The Effect of Selective Retina Therapy for Bevacizumab-Resistant Chronic Central Serous Chorioretinopathy

Ophthalmologica. 2022;245(1):91-100. doi: 10.1159/000520187. Epub 2021 Oct 14.

Abstract

Purpose: The aim of this study was to evaluate the efficacy of selective retina therapy (SRT), used in conjunction with real-time feedback dosimetry (RFD), in the treatment of bevacizumab-resistant chronic central serous chorioretinopathy (CSC).

Patients and methods: In this retrospective cohort study, 22 eyes of 22 patients with bevacizumab-resistant chronic CSC, showing focal or diffuse foveal leakages on fundus fluorescein angiography (FFA), were included. After evaluation of the test spots at temporal arcades, SRT (wavelength, 527 nm; pulse repetition rate, 100 Hz; ramping over maximal 15 micropulses; and spot diameter, 200 μm) using RFD was applied to the leakage sites observed on FFA. Changes in the mean best-corrected visual acuity (BCVA), central macular thickness (CMT), and subretinal fluid (SRF) height were evaluated at baseline and at 1, 3, 6, 9, and 12 months following treatment.

Results: SRF completely resolved in 81.8% (18/22 eyes) cases at 12 months post-treatment. The mean BCVA (logarithm of the minimum angle of resolution [logMAR]) improved from 0.49 ± 0.29 at baseline to 0.43 ± 0.36 at 12 months (p = 0.067). The mean BCVA gain was 0.06 logMAR, equivalent to 3 ETDRS letters. The CMT significantly decreased from 323 ± 85.6 μm at baseline to 221.5 ± 60.4 μm at 12 months (p < 0.001). The mean SRF height also significantly decreased from 174.6 ± 86.4 μm at baseline to 35.1 ± 75.4 μm at 12 months (p < 0.001).

Conclusion: SRT showed favorable visual and anatomical outcomes in patients with bevacizumab-resistant chronic CSC.

Keywords: Bevacizumab-resistant; Chronic central serous chorioretinopathy; Real-time feedback-controlled dosimetry; Retinal pigment epithelium; Selective retina therapy.

MeSH terms

  • Bevacizumab
  • Central Serous Chorioretinopathy* / diagnosis
  • Central Serous Chorioretinopathy* / drug therapy
  • Central Serous Chorioretinopathy* / surgery
  • Chronic Disease
  • Fluorescein Angiography
  • Humans
  • Retina
  • Retrospective Studies
  • Tomography, Optical Coherence
  • Treatment Outcome
  • Visual Acuity

Substances

  • Bevacizumab