• Written By: Nancy Eve Thomas, MD
    Comprehensive Ophthalmology

    The authors conducted this small retrospective case series to evaluate the effectiveness of intravitreal injection of Avastin (bevacizumab) for the treatment of central serous chorioretinopathy. The results suggest a possible role of vascular endothelial growth factor in the pathogenesis of central serous chorioretinopathy.

    The authors retrospectively reviewed the charts of six patients (six eyes) with central serous chorioretinopathy who had symptoms for more than three months, a history of recurrent untreated central serous chorioretinopathy and received an off-label intravitreal bevacizumab injection. They were followed for a mean of nine months.

    Mean visual acuity increased from 40.8 Early Treatment Diabetic Retinopathy Study (ETDRS) letters at baseline to 49.0 ETDRS letters one month after treatment (P = 0.046) and 53.3 ETDRS letters after three months (P = 0.028). Mean central macular thickness decreased from 331.5 µm at baseline to 164 µm at three months (P = 0.043). Leakage on fluorescein angiography and hyperpermeability on indocyanine green angiography decreased in conjunction with improvement in central macular thickness observed by optical coherence tomography.

    Findings that choroidal vascular congestion on indocyanine green angiography subsided one month after intravitreal bevacizumab injection indicate that the level of VEGF was related to central serous chorioretinopathy, the authors said. Decreasing the duration of retinal detachment from retinal pigment epithelium by reducing VEGF levels could reduce the risk of photoreceptor degeneration and improve long-term visual acuity.

    The authors conclude that intravitreal bevacizumab injection reduced the leakage associated with central serous chorioretinopathy and resulted in improved visual acuity and anatomical results in patients with the condition. Anti-VEGF injection may help resolve central serous chorioretinopathy particularly in cases that do not resolve spontaneously, have not been helped by focal thermal laser or involve the fovea and therefore are not suitable for laser treatment.