Abstract
Purpose :
Development of choroidal neovascularization (CNV) secondary to Central Serous Chorioretinopathy (CSCR) is a rare entity with an incidence from 2% to 9%, with no established standard treatment.We present our data on the clinical characteristics and treatment outcomes in this condition.
Methods :
This is a retrospective interventional case series of consecutive patients with an angiographic diagnosis of CNV secondary to CSCR, who were treated at a single tertiary medical retina unit between 2011 and 2016. Collected data includes demographic details, clinical characteristics, best-corrected visual acuity (BCVA), and OCT features at presentation and final follow-up, and mode of treatment. Main outcome measure was the proportion of eyes that had improved, stable, or worse vision at the final follow-up.
Results :
Twenty-one eyes of 21 patients, of whom 12 were male, were included. Mean age at diagnosis of CSCR was 52.57 years (range 24-77 years). Six were right eyes. Nine eyes had received half-dose photodynamic therapy (PDT) for CSCR and the rest were untreated. Mean interval between diagnosis of CSCR and diagnosis of CNV was 34.85 months. Sub-type of CNV was occult in 14 and classic in 7 eyes respectively. 14 eyes received anti-vascular endothelial growth factor intravitreal (anti-VEGF) therapy only, 4 had PDT only and 3 had a combination of anti-VEGF and PDT for the CNV. Mean follow-up duration (range) was 18.95 (1-65) months. Mean number of injections during the follow-up was 9 in the group with anti-VEGF monotherapy and 6.42 in the group with combination therapy.
The mean gain in BCVA was 5.23 letters (±7.02 letters). Mean gain in BCVA in eyes with previous PDT for CSCR was 4.85 letters. Visual acuity improved in 14 (66.66%),remained stable in 2 (9.52%) and worsened in 5 (23.80%) eyes overall.Mean gain in BCVA was 5.43, 4.25 and 5.43 letters in patients receiving anti-VEGF monotherapy, PDT only and combination treatment respectively.Mean central subfield thickness (SD) on OCT was 354.67(± 64.12) at baseline and reduced to 252.21 (±34.43) microns at final follow-up.Subretinal fluid was present in all cases at baseline and only in 6 eyes at final follow-up on OCT.There were no adverse events noted.
Conclusions :
Anti-VEGF therapy either as monotherapy or in combination with PDT is effective for CNV secondary to CSCR including in eyes previously treated with PDT for CSCR.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.