Ron A. Adelman, Shelly T. Lee (New Haven, FL, USA)

Advantages:

Intravitreal injection of bevacizumab may be effective in patients with recurrent central serous chorioretinopathy (CSC).

Methods:

A retrospective study of patients with a diagnosis of recurrent CSC who were treated with intravitreal bevacizumab from January 2007 – January 2009. 1.5 mg injections of bevacizumab were given once every 4 weeks as long as there was sub-retinal fluid. We studied pre-injection visual acuity, ocular coherence tomography (OCT), fluorescein angiography imaging, number of injections administered, OCT data after each injection, and visual acuity after each injection. Each patient was followed for a minimum of 6 months.

Effectiveness / Safety:

Three patients with recurrent CSC were included in the analysis. Mean baseline visual acuity was 0.30 logMAR, with a median of 0.30 logMAR. Mean post-bevacizumab visual acuity was 0.03, 0.07, 0.03 logMAR at 1, 3, and 6 months respectively. Median post-bevacizumab acuity was 0, 0.10, and 0 logMAR at 1, 3, and 6 months respectively. Baseline pre-injection central macular thickness (CMT) by OCT imaging ranged from 320 microns to 500 microns, with a mean of 388 microns and a median of 344 microns. Mean CMT at month 1 was 248 microns, with a median of 190 microns. Mean CMT at month 3 was 252 microns, with a median of 281 microns. Mean CMT at month 6 was 273 microns, with a median of 187 microns.

Take home message:

Intravitreal bevacizumab may be an effective treatment for patients with recurrent CSC. Despite the fact that long-term efficacy is unknown, intravitreal bevacizumab is a relatively low-risk therapy that may improve visual acuity and CMT.