gms | German Medical Science

Background: To determine the anatomical and functional outcome of an extended 6-month intravitreal anti-vascular endothelial growth factor (anti-VEGF) upload in choroidal neovascularization (CNV) secondary to chronic central serous chorioretinopathy (CSC).

Methods: A retrospective analysis of patients treated with an extended upload of six consecutive injections of intravitreal anti-VEGF for secondary CNV in chronic CSC was performed. Main outcome measure was anatomical response as represented by the change of central retinal subfield thickness measured on spectral domain optical coherence tomography (Heidelberg Spectralis^®). Secondary outcome measures included change in visual acuity and further imaging biomarkers of chronic CSC.

Results: In a database of 2498 patients treated with intravitreal injections between 01/2016 and 12/2018, 140 patients treated with anti-VEGF injections for secondary CNV complicating chronic CSC were identified. Of these, 21 eyes of 21 patients were found eligible for the above-mentioned criteria. Mean patient age at the first injection was 65±8.3 years and 35% of the patients (n=8) were female. Mean disease duration before diagnosis of CNV was 48+25.3 months. Four patients (19%) had been treated with a half-fluence photodynamic therapy prior to developing CNV. Mean central retinal thickness decreased from 346±61,0µm to 257±57.4µm (p<0.01) after the sixth injection while mean visual acuity improved (0.65±0.35 vs. 0.49±0.29 logMAR; p<0.05). Notedly, there was a significant further reduction of the mean central retinal thickness after the third injection (280±45.6µm vs. 257±57.4µm, p<0.05). No adverse events were recorded in the observation period.

Conclusion: Favorable anatomical

Results: can be achieved by a strict anti-VEGF injection regimen in CNV complicating chronic CSC. Significant gains of visual acuity are feasible but, however, limited by the underlying disruption of outer retinal layers owing to the chronicity of CSC.