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

• Published in: Eye (London) Vol. 29; no. 6; pp. 732 - 741
• Main Authors: Kim, G A, Rim, T H, Lee, S C, Byeon, S H, Koh, H J, Kim, S S, Lee, C S
• Format: Journal Article
• Language: English
• Published: England Nature Publishing Group 01.06.2015
• Subjects: Adult; Angiogenesis Inhibitors - administration & dosage; Angiogenesis Inhibitors - therapeutic use; Bevacizumab - administration & dosage; Bevacizumab - therapeutic use; Central Serous Chorioretinopathy - diagnosis; Central Serous Chorioretinopathy - drug therapy; Central Serous Chorioretinopathy - physiopathology; Clinical Study; Female; Fluorescein Angiography; Humans; Intravitreal Injections; Male; Middle Aged; Retrospective Studies; Subretinal Fluid - drug effects; Tomography, Optical Coherence; Treatment Outcome; Vascular Endothelial Growth Factor A - antagonists & inhibitors; Visual Acuity - physiology
• ISSN: 0950-222X; 1476-5454
• DOI: 10.1038/eye.2015.58

To investigate factors associated with good response to intravitreal bevacizumab (IVB) in central serous chorioretinopathy (CSC) patients. We retrospectively reviewed 42 eyes of CSC patients of symptom duration more than 3 months who received a single or multiple successive IVBs on an as-needed basis (0.05 ml, 1.25 mg). High responders (HRs) were defined as complete resolution of subretinal fluid (SRF) on spectral domain optical coherence tomography (SD-OCT). Moderate responders (MRs) were defined as SRF resolution of 50-99% of pretreatment volume and poor responders (PRs) as SRF resolution <50%. Clinical, SD-OCT, fluorescein, and indocyanine green angiography findings were analyzed to find factors associated with HR. Descriptive statistics for all demographic and clinical variables were calculated, and comparisons were made using Wilcoxon's matched-pairs signed-rank test, the Mann-Whitney U-test for means with continuous data, Pearson's χ(2) test, and Fisher's exact test for categorical data. The mean number of IVB was 1.9. At postoperative 1 month, there were 10 (24%) HRs, 18 (43%) MRs, and 14 (33%) PRs. At the last follow-up (the mean 8.6 months), there were 25 HRs (60%), 9 MRs (21%), and 8 PRs (19%). Thicker subfoveal choroid (P=0.036), smaller lesion diameter (P=0.019), and better baseline best-corrected visual acuity (P=0.002) predicted HRs at postoperative 1 month. HR at the last follow-up was associated with classic pattern fluorescein angiography finding. Suboptimal effects of IVB on persistent CSC suggest primary IVB on selective cases with better vision, smaller lesion, and thicker choroid at baseline.