Abstract
Purpose :
To investigate the 12-month outcome of intravitreal Bevacizumab on the structure and function of eyes with central serous chorioretinopathy-related choroidal neovascularization (CNV-CSCR)
Methods :
Patients with a diagnosis of CNV-CSCR were identified retrospectively from Moorfields Eye Hospital database. Eyes that received Avastin with at least 1-year follow up were included in this study. Optical coherence tomography (OCT) and fluorescein angiography (FA) were initially used to identify eyes with "presumed" CNV. OCT angiography (OCTA) was consequently used to confirm the presence of neovascular membrane and establish the diagnosis of “definite” CNV. "No CNV" group included eyes with no evidence of CNV on OCTA. ETDRS visual acuity (VA) was reported, and central retinal (CRT) and choroidal thicknesses (CCT) were measured from OCT at baseline, and after 1-year of the first injection. Baseline OCT scans were also qualitatively reviewed to detect anatomical features. Positive response to treatment was defined as either a decrease of at least 20% of baseline CRT, or ≥5 letters increase in ETDRS VA.
Results :
Sixty one eyes with CSCR from 58 patients were selected (table1). Multimodal imaging did not show signs of CNV in 15 eyes (24.6%, No CNV group). OCTA confirmed the presence of CNV in 18 eyes (29.5%, definite CNV group). The remaining 28 eyes (45.9%) had suspicious OCT/FA findings, with no OCTA scans to confirm the diagnosis (presumed CNV group). The presence of hyperreflective double layer sign on OCT associated with the detection of CNV on OCTA (odds ratio=10.4, p=0.017, logistic regression). Significant reduction in mean CRT and improvement in VA were observed at 1-year follow up in the definite and presumed CNV groups (P<0.05, Wilcoxon), but not the No CNV group. Positive response to injection was detected in 100% of eyes in definite CNV, 71% in presumed CNV, and 67% of No CNV group (p=0.007, Likelihood ratio χ2). No significant change in CCT was detected in any of the groups after treatment (p>0.1). No OCT features predicted the response to Bevacizumab in our cohort.
Conclusions :
The diagnosis of CNV in eyes with chronic CSCR is challenging, requiring multimodal imaging including OCT angiography. Intravitreal Bevacizumab had a positive effect on CRT and VA in CNV-CSCR eyes. No relationship was detected between baseline OCT features and response to injection.
This is a 2020 ARVO Annual Meeting abstract.