Raphaël Lejoyeux1,2,3,4,5,6, Francine Behar-Cohen1,2, Irmela Mantel3, Jorge Ruiz-Medrano3, Sarah Mrejen4, Ramin Tadayoni5,6, Alain Gaudric5, Elodie Bousquet7,8. 1. Department of Ophthalmology, OphtalmoPôle, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, AP-HP, University of Paris, Paris, France. 2. INSERM U1138, Team 17, University of Paris, Centre de Recherche des Cordeliers, Paris, France. 3. Department of Ophthalmology, Jules Gonin Eye Hospital, Fondation Asile des Aveugles, University of Lausanne, Lausanne, Switzerland. 4. Department of Ophthalmology, Centre Hospitalier National des Quinze-Vingts, University of Paris, Paris, France. 5. Department of Ophthalmology, Université de Paris, AP-HP, Hôpital Lariboisière, F-75010, Paris, France. 6. Retina Department, Fondation Rothschild Hospital, Paris, France. 7. Department of Ophthalmology, OphtalmoPôle, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, AP-HP, University of Paris, Paris, France. elodie.bousquet@aphp.fr. 8. INSERM U1138, Team 17, University of Paris, Centre de Recherche des Cordeliers, Paris, France. elodie.bousquet@aphp.fr.
Abstract
PURPOSE: The aim of this study was to assess the short-term effect of anti-vascular endothelial growth factor (VEGF) treatment on type 1 macular neovascularization (MNV) secondary to central serous chorioretinopathy (CSCR) and to identify potential predictive factors for treatment response using multimodal imaging. METHODS: Retrospective, multicentre study in CSCR patients with MNV detected by OCT-angiography and treated with anti-VEGF injections. Clinical and multimodal imaging data before and after anti-VEGF injections was reviewed. Univariate and multivariate linear regression analyses were performed to evaluate associations between the change in central macular thickness (CMT) after anti-VEGF therapy and other factors. RESULTS: Forty patients were included. One month after receiving a mean number of 2.7 anti-VEGF intravitreal injections, visual acuity increased significantly from 0.46 ± 0.3 logMAR at baseline to 0.38 ± 0.4 logMAR (p = 0.04). The CMT and foveal serous retinal detachment (SRD) decreased significantly from 330 ± 81.9 µm at baseline to 261.7 ± 63.1 µm after treatment (p < 0.001) and from 145.1 ± 98.8 µm at baseline to 52.6 ± 71.3 µm (p < 0.001), respectively. Subretinal fluid and/or intraretinal fluid were still present in 18 eyes (45%) one month after treatment. In the multivariate analysis, a higher SRD height was associated with a greater CMT change (p = 0.002) and a lower CMT change with the presence of subretinal hyperreflective material (SHRM) (p = 0.04). CONCLUSION: Fluid resorption was incomplete in about half of the patients with MNV secondary to CSCR after anti-VEGF injections. Shallower SRD or the presence of SHRM were predictors of poor response to anti-VEGF.
PURPOSE: The aim of this study was to assess the short-term effect of anti-vascular endothelial growth factor (VEGF) treatment on type 1 macular neovascularization (MNV) secondary to central serous chorioretinopathy (CSCR) and to identify potential predictive factors for treatment response using multimodal imaging. METHODS: Retrospective, multicentre study in CSCR patients with MNV detected by OCT-angiography and treated with anti-VEGF injections. Clinical and multimodal imaging data before and after anti-VEGF injections was reviewed. Univariate and multivariate linear regression analyses were performed to evaluate associations between the change in central macular thickness (CMT) after anti-VEGF therapy and other factors. RESULTS: Forty patients were included. One month after receiving a mean number of 2.7 anti-VEGF intravitreal injections, visual acuity increased significantly from 0.46 ± 0.3 logMAR at baseline to 0.38 ± 0.4 logMAR (p = 0.04). The CMT and foveal serous retinal detachment (SRD) decreased significantly from 330 ± 81.9 µm at baseline to 261.7 ± 63.1 µm after treatment (p < 0.001) and from 145.1 ± 98.8 µm at baseline to 52.6 ± 71.3 µm (p < 0.001), respectively. Subretinal fluid and/or intraretinal fluid were still present in 18 eyes (45%) one month after treatment. In the multivariate analysis, a higher SRD height was associated with a greater CMT change (p = 0.002) and a lower CMT change with the presence of subretinal hyperreflective material (SHRM) (p = 0.04). CONCLUSION: Fluid resorption was incomplete in about half of the patients with MNV secondary to CSCR after anti-VEGF injections. Shallower SRD or the presence of SHRM were predictors of poor response to anti-VEGF.
Authors: Adnan Tufail; Nirodhini Narendran; Praveen J Patel; Sobha Sivaprasad; Winfried Amoaku; Andrew C Browning; Olayinka Osoba; Richard Gale; Sheena George; Andrew J Lotery; Mohammed Majid; Martin McKibbin; Geeta Menon; Christopher Andrews; Christopher Brittain; Aaron Osborne; Yit Yang Journal: Ophthalmology Date: 2013-09 Impact factor: 12.079
Authors: David M Brown; Mark Michels; Peter K Kaiser; Jeffrey S Heier; Judy P Sy; Tsontcho Ianchulev Journal: Ophthalmology Date: 2009-01 Impact factor: 12.079