Treatment of acute CSC was dependent on patient status and demand. Observation was recommended for at least 1 month. After 1 month of observation, several options were recommended such as focal laser photocoagulation, intravitreal bevacizumab injection, or further observation. All potential risks and benefits of each treatment were explained to the patients.
Intravitreal injections of bevacizumab (Avastin, 25 mg/mL; Genentech, Inc., South San Francisco, CA, USA) were given after applying at least three drops of topical anesthetic (Alcaine; Alcon, Aliso Viejo, CA, USA). After disinfection and draping, a 0.05-mL volume containing 1.25 mg of bevacizumab was injected into the vitreous cavity, using a 30-gauge needle at a distance of 3.0 to 3.5 mm from the limbus, according to lens status. After the injection, a topical antimicrobial drug, levofloxacin ophthalmic solution (Cravit; Santen Pharmaceutical Co., Ltd., Osaka, Japan) was administered 4 times a day for a week.
Focal laser photocoagulation was applied at the leaking point, which was detected by FAG. The Patterned Scanning Laser (PASCAL; OptiMedica Corp., Santa Clara, CA, USA) was used for treatment. Direct treatment of the leaking spot was conducted by using burns of 100 to 200 μm in diameter, unless the leak was immediately under the subfoveal area. Intensity and duration of the laser burns varied between 150 and 250 mW and 20 and 30 ms respectively.