Author: Patricia Tacata (Philippines)
Co-authors: Kent Wee, Janice Marie Jordan-Yu
Purpose
This study aims to compare visual and anatomical outcomes of intravitreal anti-VEGF versus observation alone in the treatment of acute central serous chorioretinopathy among a cohort of Filipino eyes, within 4 months of follow-up.
Setting/Venue
In this retrospective comparative study, a dataset of a cohort of patients diagnosed with acute CSCR between January 2013 to June 2020 were reviewed and analyzed in a single tertiary hospital.
Methods
In this retrospective comparative study, a cohort of 49 eyes diagnosed with acute CSCR were reviewed and analyzed. Within the cohort are 29 eyes treated with intravitreal anti-VEGF (IVT group) and 20 eyes with observation. Best-corrected visual acuity (BCVA), central subfoveal retinal thickness (CSRT) measurement and subretinal fluid (SRF) optical coherence tomography (OCT), leakage in fundus angiography (FA) and presence of visual distortion at baseline and 4 months follow-up were collected and analyzed.Subjects with incomplete data were excluded. Furthermore, excluded in the study were subjects who received retinal laser therapy, those with coexisting retinal diseases and maculopathies capable of causing macular exudation such as age related macular degeneration, diabetic or uveitic retinopathy, and non-retinal diseases that can contribute to central blurring of vision such as glaucoma, dense cataract and corneal opacity.
Results
All patients in both study groups demonstrated improvement in visual acuity at the end of 4 months. Comparison within groups regarding mean VA (p=0.816) and CSRT (p=0.177) improvement from baseline of were also comparable between groups. However, the IVT group had statistically lower CSRTs vs observation group (237 ± 32 um vs 339 ± 248 um, p=0.003) at month 4. Significant resolution of SRF (23 to 2 vs 19 to 12, p=0.000), FA leakage (26 to 3 vs 20 to 9, p=0.010) and visual distortion (24 to 4 vs 16 to 11, p=0.004) in the IVT group vs the observation group was noted at month 4. Subgroup analysis of the IVT group, aflibercept (10 eyes) vs ranibizumab (16 eyes) in terms of visual acuity (p=0.997) and CSRT (p=0.877), as well as, mean improvement in VA (p= 0.254) and CSRT (p= 0.827) from baseline at month 4 of follow-up showed comparable results.
Conlusions
Compared with observation alone, intravitreal anti-VEGF did not have positive effect in terms of the final visual acuity at 4th month of follow-up in a cohort of Filipino eyes diagnosed with acute CSCR. However, intravitreal anti-VEGF offered earlier improvement in visual acuity, resolution of visual distortion, subretinal fluid, and angiographic leakage.
Financial Disclosure
None
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