Abstract
Purpose :
To evaluate the long term efficacy of the Intravitreal Anti-VEGF injection on the visual outcome in the treatment of Choroidal Neovascular Membrane (CNV) secondary to Chronic Central Serous Chorioretinopathy (CSCR) and its correlation with the morphological characteristics in Optical Coherence Tomography (OCT).
Methods :
This study included patients recruited retrospectively from Moorfields Eye Hospital Electronic Medical Record system who had received intravitreal Anti-VEGF injection as a monotherapy in treating CNV secondary to CSCR. Patients were treated with either bevacizumab, ranibizumab, or aflibercept, depending on the standard of care. Best corrected visual acuity (ETDRS), Number of injections, and OCT morphological changes were recorded.
Results :
Seventy-eight eyes from 72 patients (63.9 % males) with CNV secondary to chronic CSCR were included in the study with a mean baseline age (66.68 ± 12.86) years. The mean injection number was (12.33 ± 11.65) in a mean follow up period (37.43 ±23.67) months. Of the included patients, 57.69% received aflibercept, 34.62% received bevacizumab, while ranibizumab was injected in 24.36%. Switching between anti-VEGF was recorded in 19.23% of patients. The mean baseline visual acuity was 57.31±17.80 letters, whereas post injection treatment mean visual acuity was 61.92±18.56 letters. There was a significant difference between the pre and post injection (p =0.021). No significant correlation detected between number of injection and visual outcome (p =0.54). Improvement in visual acuity by five letters or more (mean 18.24±12.88 letters) was recorded in 48.72%, while in 24.36% the visual acuity was stable. In 26.92 % visual acuity deteriorated by 5 letters or more (mean -16.11±11.61). of these, EZ disruption was detected in 94.73%, disciform scar was detected in 42.10 %. Intraretinal cystic spaces was detected in 52.63% compared to only 18.42% in whom visual improvement was recorded. No significant correlation between visual outcome and both SRF or SRHM.
Conclusions :
Intravitreal Anti-VEGF injection is effective in treating CNV secondary to CSCR. Visual outcome is influenced by the morphological changes in the structural OCT, in which EZ disruption, disciform scar and intraretinal fluid have poor prognostic index.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.