Back to Search
Start Over
Predictors of treatment response to intravitreal anti-vascular endothelial growth factor (anti-VEGF) therapy for choroidal neovascularisation secondary to chronic central serous chorioretinopathy.
- Source :
-
The British journal of ophthalmology [Br J Ophthalmol] 2020 Jul; Vol. 104 (7), pp. 910-916. Date of Electronic Publication: 2019 Oct 15. - Publication Year :
- 2020
-
Abstract
- Purpose: The aim of this study was to evaluate the effect of anti-vascular endothelial growth factor (VEGF) therapy on choroidal neovascularisation (CNV) complicating central serous chorioretinopathy (CSC) using multimodal imaging, and to identify possible predictive factors of the treatment response.<br />Design: Retrospective study.<br />Methods: Data of 27 eyes with CNV complicating CSC treated with anti-VEGF therapy (either ranibizumab or aflibercept) were reviewed. Response to anti-VEGF treatment was evaluated by change in visual acuity, intra/subretinal fluid modifications and CNV changes on optical coherence tomography angiography (OCTA). Univariate and multivariate analyses were performed to identify predictive factors for central retinal thickness (CRT) change and for the relative degree of treatment response (complete, incomplete or absent fluid reduction).<br />Results: CRT was significantly reduced at 32±15 days after 2.8±1.3 injections (p=0.0004) as was the subretinal fluid (p=0002). Complete fluid resorption was observed in 45% of cases. Best corrected visual acuity did not significantly improve (p=0.18). CNV area (p=0.09) and CNV flow area (p=0.07) did not significantly decrease. No changes in CNV pattern were noted. Univariate analysis identified greater CRT at baseline (p<0.0001), greater amount of subretinal fluid (p<0.0001), a shorter period of retinal fluid (p=0.04) and female gender (p=0.04) as predictors for CRT reduction. After multivariate analysis the factor of greater CRT at baseline (p<0.0001) proved independent. The degree of treatment response was dependent on the size of CNV surface (p=0.05) and flow area (p=0.05) on OCTA in the univariate analysis, and the latter independent after multivariate analysis. In addition, a shorter time period of retinal fluid appeared to play a role (p=0.01 multivariate, p=0.19 univariate).<br />Conclusion: The anti-VEGF response was highly variable and often incomplete, suggesting that CNV was not solely responsible for the fluid accumulation. Predictive factors may guide indication for anti-VEGF in CNV associated with CSC.<br />Competing Interests: Competing interests: None declared.<br /> (© Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.)
- Subjects :
- Aged
Central Serous Chorioretinopathy physiopathology
Choroidal Neovascularization diagnostic imaging
Choroidal Neovascularization etiology
Choroidal Neovascularization physiopathology
Chronic Disease
Coloring Agents administration & dosage
Female
Fluorescein Angiography
Humans
Indocyanine Green administration & dosage
Intravitreal Injections
Male
Middle Aged
Multimodal Imaging
Ranibizumab therapeutic use
Receptors, Vascular Endothelial Growth Factor therapeutic use
Recombinant Fusion Proteins therapeutic use
Retrospective Studies
Subretinal Fluid
Tomography, Optical Coherence
Treatment Outcome
Visual Acuity physiology
Angiogenesis Inhibitors therapeutic use
Central Serous Chorioretinopathy complications
Choroidal Neovascularization drug therapy
Vascular Endothelial Growth Factor A antagonists & inhibitors
Subjects
Details
- Language :
- English
- ISSN :
- 1468-2079
- Volume :
- 104
- Issue :
- 7
- Database :
- MEDLINE
- Journal :
- The British journal of ophthalmology
- Publication Type :
- Academic Journal
- Accession number :
- 31615761
- Full Text :
- https://doi.org/10.1136/bjophthalmol-2019-314625