Intravitreales Bevacizumab bei chronischer Retinopathia centralis serosa

Niegel, Michael; Schrage, Norbert; Christmann, S.; Degenring, Robert F.

doi:10.1007/s00347-008-1691-5

Cited by 10 publications

(6 citation statements)

References 7 publications

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“…Contrary to previous reports, however, the result was disappointing as the patient's BCVA continued to decline [10, 14]. Another possible therapeutic option in our patient was the use of focal argon laser coagulation at sites of leakage [1].…”

Section: Discussioncontrasting

confidence: 70%

“…Lately, it has been suggested that reducing the light dose (fluence) is safer because standard PDT may cause severe choroidal ischaemia [9], while low-fluence PDT minimizes the risk of Bruch's membrane rupture. Intravitreal anti-vascular endothelial growth factor administration is an alternative approach to CSCR management [10] which has been recently suggested. It is believed that anti-vascular endothelial growth factor exerts its effects by reducing the permeability of the choriocapillaris vessels and tightening the blood-retina barrier.…”

Section: Discussionmentioning

confidence: 99%

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Multifocal Central Serous Chorioretinopathy Associated with Steroids in a Patient with Myasthenia Gravis

Stefaniotou¹,

Vourda²,

Katsanos³

et al. 2013

Case Rep Ophthalmol

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We present a case of bilateral multifocal central serous chorioretinopathy in a 40-year-old male who suffered from myasthenia gravis and was receiving oral prednisolone. Due to the severity of the underlying disease, it was not possible to reduce the corticosteroid dose. After initial unsuccessful treatment with an intravitreal injection of ranibizumab, low-fluence photodynamic therapy was performed, followed by gradual tapering of the corticosteroids. Visual acuity improved significantly in both eyes. Different therapeutic approaches are discussed.

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Section: Discussioncontrasting

confidence: 70%

Section: Discussionmentioning

confidence: 99%

Multifocal Central Serous Chorioretinopathy Associated with Steroids in a Patient with Myasthenia Gravis

Stefaniotou¹,

Vourda²,

Katsanos³

et al. 2013

Case Rep Ophthalmol

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“…Intravitreal injection of bevacizumab is another recent approach to the treatment of CSCR 58. Growing literature highlights how this type of treatment has a degree of effectiveness in reducing neuroepitelial detachment and choroidal hyperpermeability.…”

Section: Treatmentmentioning

confidence: 99%

Central serous chorioretinopathy: a pathogenetic model

Caccavale¹,

Romanazzi²,

Imparato

et al. 2011

OPTH

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Despite numerous studies describing predominantly its demography and clinical course, many aspects of central serous chorioretinopathy (CSCR) remain unclear. Perhaps the major impediment to finding an effective therapy is the difficulty of performing studies with large enough cohorts, which has meant that clinicians have focused more on therapy than on a deeper understanding of the pathogenesis of the disease. Hypotheses on the pathogenesis of CSCR have ranged from a basic alteration in the choroid to an involvement of the retinal pigment epithelium (RPE). Starting from evidence that affected subjects often present a personality prone to stress with altered pituitary–hypothalamic axis response (HPA) and that they have higher levels of serum and urinary cortisol and catecholamines than healthy subjects, we hypothesize a cascade of events that may lead to CSCR through hypercoagulability and augmented platelet aggregation. In particular we investigated the role of tissue plasminogen activator, increasing plasminogen activator inhibitor 1 (PAI-1), and plasmin-α2- plasmin inhibitor complexes. We reviewed the different therapeutic approaches, including adrenergic antagonists, carbonic anhydrase inhibitors, mifepristone, ketoconazole, laser photocoagulation, intravitreal injection of bevacizumab, and photodynamic therapy with verteporfin (PDT) and our model of pathogenesis seems to be in agreement with the clinical effects obtained from these treatments. In accord with our thesis, we began to treat a group of patients affected by CSCR with low-dose aspirin (75–100 mg), because of its effectiveness in other vascular diseases and its low ocular and general toxicity with prolonged use. The formulation of a causative model of CSCR enables us to understand how the therapeutic approach cannot be based on a generalized therapy but should be individualized for each patient, and that sometimes a combined strategy of treatment is required. Moreover a complete knowledge of the disease will help to identify patients prone to the most persistent forms of CSCR, and thus help to find a treatment.

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“…Recently there has been a case report suggesting that intravitreal application of bevacizumab, a humanized monoclonal antibody to VEGF, may have beneficial effects in chronic CSC [18]. However, we used intravitreal bevacizumab injection for treatment in a few cases of acute CSC.…”

Section: Introductionmentioning

confidence: 99%

Intravitreal Bevacizumab to Treat Acute Central Serous Chorioretinopathy: Short-Term Effect

et al. 2009

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Aims: To report the beneficial effect of intravitreal bevacizumab (Avastin) injection in patients with acute central serous chorioretinopathy. Methods: Ten eyes of 10 patients with acute central serous chorioretinopathy received an intravitreal bevacizumab (1.25 mg/0.05 ml) injection. At baseline and follow-up visits patients had best corrected visual acuity (BCVA), IOP assessment, dilated fundus examination and OCT imaging. Main outcome measures were the resolution of neurosensory detachment, improvement in visual symptoms and visual acuity. Results: All patients showed resolution of neurosensory detachment promptly, and improvement in visual acuity and symptoms within 1 month. In 1 case, fluorescein leakage resolved and neurosensory detachment nearly resolved at 2 weeks after treatment. At 6 months the mean BCVA (LogMAR) had improved from 0.32 to 0.04, which was statistically significant (p = 0.007, Wilcoxon signed ranks test). No recurrence was observed during a 6-month follow-up. Conclusions: Intravitreal bevacizumab injection for acute central serous chorioretinopathy may result in prompt resolution of neurosensory detachment and reduction of angiographic leakage. These short-term results suggest that intravitreal bevacizumab injection may constitute a promising therapeutic option in acute central serous chorioretinopathy.

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Intravitreales Bevacizumab bei chronischer Retinopathia centralis serosa

Cited by 10 publications

References 7 publications

Multifocal Central Serous Chorioretinopathy Associated with Steroids in a Patient with Myasthenia Gravis

Multifocal Central Serous Chorioretinopathy Associated with Steroids in a Patient with Myasthenia Gravis

Central serous chorioretinopathy: a pathogenetic model

Intravitreal Bevacizumab to Treat Acute Central Serous Chorioretinopathy: Short-Term Effect

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