Clinical efficacy of anti-VEGF medications for central serous chorioretinopathy: a meta-analysis

Int J Clin Pharm. 2017 Jun;39(3):514-521. doi: 10.1007/s11096-017-0460-4. Epub 2017 Apr 6.

Abstract

Background Central serous chorioretinopathy (CSC) is a widespread retinal disorder, and 30-50% of patients eventually result in retinal pigment epithelium atrophy and irreversible vision loss. Aim of the review To evaluate the effectiveness of medications based on anti-vascular endothelial growth factor (anti-VEGF) on central serous chorioretinopathy (CSC). Method A systematic search on anti-VEGF medication treatments for CSC was performed in Pubmed, Embase, and the Cochrane Library prior to May 2016. The main outcome variables were best-corrected visual acuity (BCVA) and central macular thickness (CMT). All effects were analyzed via Review Manager 5.3. Results Fourteen studies were incorporated with a total of 266 eyes, divided into a comparative group and a non-comparative group. The comparative group included acute and chronic CSC studies, while the non-comparative group included chronic CSC only. Meta-analysis revealed that for acute CSC, anti-VEGF treatment was not superior to observation at a 6-month follow-up in BCVA and CMT. For chronic CSC in the comparative group, no significant difference was observed between anti-VEGF treatment and observation in BCVA; however, the observed difference in CMT (WMD = -67.78, 95% CI 20.17-115.38) was statistically significant. In the non-comparative group, significant differences were observed after anti-VEGF treatment in BCVA and CMT at 1, 6, and 12 months follow-ups. Conclusion Our meta-analysis partially indicated that anti-VEGF medications might be a viable choice for the treatment of chronic CSC; however, due to the self-limiting nature of CSC, care should be applied in the clinical application of anti-VEGF medications.

Keywords: Anti-VEGF; Anti-vascular endothelial growth factor; Central serous; Chorioretinopathy; Meta-analysis.

Publication types

  • Meta-Analysis
  • Review

MeSH terms

  • Angiogenesis Inhibitors / pharmacology
  • Angiogenesis Inhibitors / therapeutic use*
  • Central Serous Chorioretinopathy / drug therapy*
  • Central Serous Chorioretinopathy / pathology
  • Follow-Up Studies
  • Humans
  • Macula Lutea / drug effects
  • Macula Lutea / pathology
  • Time Factors
  • Vascular Endothelial Growth Factor A / antagonists & inhibitors*
  • Visual Acuity / drug effects

Substances

  • Angiogenesis Inhibitors
  • Vascular Endothelial Growth Factor A