The efficacy of intravitreal bevacizumab for idiopathic central serous chorioretinopathy

Abstract

Intravitreal bevacizumab injections generally resulted in anatomic improvement for CSC and may constitute a therapeutic option in CSC. The effect after intravitreal bevacizumab injection for CSC might be related to the hyperfluorescence on indocyanine green angiography.

Lack of positive effect of intravitreal bevacizumab in central serous chorioretinopathy: meta-analysis and review

“…19,40 Recently, anti-VEGF antibody has been used in CSC as an off-label method. [1][2][3][22][23][24]28,30,32,33,[41][42][43] Bevacizumab is a recombinant humanized full-length monoclonal antibody of VEGF that penetrates the retina and is transported into the photoreceptor outer segments, RPE, and choroid after intravitreal injection. 44 The half-life of bevacizumab in the vitreous is 5.6 days, and it remains in the eye for 4 to 6 weeks.…”

“…2,21 There have been several off-label clinical trials of intravitreal bevacizumab injection (IVB) in CSC. 1,2,13,[22][23][24][25] Most showed positive results, with improved visual acuity and reduced subretinal fluid. However, these findings should be interpreted cautiously because of the self-limiting characteristics of CSC, which can show spontaneous improvement within months.…”

“…However, these findings should be interpreted cautiously because of the self-limiting characteristics of CSC, which can show spontaneous improvement within months. 1,2,12,[22][23][24][25] Therefore, we performed a meta-analysis of the efficacy of IVB in terms of visual acuity and macular thickness to gain a better perspective regarding the therapeutic options in CSC.…”

Clinical characteristics of responders to intravitreal bevacizumab in central serous chorioretinopathy patients

“…Various treatments, including focal photocoagulation, photodynamic therapy (PDT), anti-vascular endothelial growth factor (VEGF) intravitreal injections, corticosteroid antagonists, and acetazolamide have been used to promote the remission of persistent or recurrent CSC. [9][10][11][12][13][14] Intravitreal bevacizumab (IVB), a recombinant humanized monoclonal anti-VEGF antibody, has been reported to be effective in CSC patients with symptom durations over 3 months. 9,[15][16][17][18][19][20] In acute CSC of o3 months symptom duration, IVB may not result in therapeutic benefits compared with simply waiting for spontaneous resolution.…”

“…16,[23][24][25] Moreover, there appears to be significant individual variation in treatment responses to IVB. 9,20 CSC encompasses a wide range of patients with varying degrees and patterns of angiographical and tomographical manifestations. Previous studies have validated the general efficacy and safety of IVB for CSC, but it is largely unknown what factors would predict favorable or unfavorable response to this treatment.…”