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Gyu Ah Kim, Tyler Hyung Taek Rim, Christopher Lee, SungChul lee; Clinical characteristics of responders to intravitreal Bevacizumab in central serous chorioretinopathy patients. Invest. Ophthalmol. Vis. Sci. 2013;54(15):3850.
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Bevacizumab has been reported to be effective in central serous chorioretinopathy(CSC). We investigated the clinical factors associated with response to intravitreal bevacizumab(IVB) in CSC patients.
We retrospectively reviewed the medical charts of 48 eyes of 48 patients with CSC who received IVB (0.05ml, 1.25mg) and followed up for at least 3 months from November 2009 through December 2012. “Good responder” was defined as complete resolution of subretinal fluid(SRF) on spectral domain optical coherence tomography(SD-OCT) within 1month following a single session of IVB. Eyes that showed partial or no resolution of SRF were grouped as “poor responder”. Subfoveal choroidal thickness and basal diameter of detached retina were measured on SD-OCT. Number of leakage sites, distance of leaking point from foveal center, and CSC type classification (“classic” or “diffuse retinal pigment epitheliopathy”) were analyzed using fluorescein angiography(FA).
There were 10 (20.8%) good responders and 38 (79.2%) poor responders. The mean follow-up was 4.3months. No significant difference was noted between the 2 groups with respect to demographic characteristics including age, gender, and spherical equivalent except preoperative visual acuity(p<0.01). There was no statistical difference between 2 groups with respect to CSC types, number of leakage sites, and distance to the nearest leakage site. The largest basal diameter of detached retina was significantly smaller in good responders than poor responders (1215±383µm vs. 1605±469µm; p=0.03). Subfoveal choroidal thickness was significantly thicker in good responders than poor responders (485.0±104.2µm vs. 379.2± 137.5µm; p=0.04). According to receiver operator characteristic(ROC) analysis, subfoveal choroidal thickness was characteristic parameter of good responder with area under the curve of 0.74. The cut-off value of 434µm were determined by ROC curve with 77.8% sensitivity and 70.0% specificity. Subjects with ≥434µm of choroidal thickness were more likely to be a good responder (Odds ratio = 5.43, 95CI, 1.06-27.8).
We found that thicker choroid and smaller basal diameter of the detached retina in CSC predict good response to IVB. This may imply an important role of choroid in CSC.
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