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Graefe's Archive for Clinical and Experimental Ophthalmology

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Open Access 01-05-2020 | Ranibizumab | Retinal Disorders

Response of neovascular central serous chorioretinopathy to an extended upload of anti-VEGF agents

Authors: Benedikt Schworm, Nikolaus Luft, Leonie F. Keidel, Felix Hagenau, Christoph Kern, Tina Herold, Karsten U. Kortuem, Siegfried G. Priglinger, Jakob Siedlecki

Published in: Graefe's Archive for Clinical and Experimental Ophthalmology | Issue 5/2020

Abstract

Purpose

To determine the anatomical and functional outcomes of an extended 6-month intravitreal anti-vascular endothelial growth factor (anti-VEGF) upload in choroidal neovascularization (CNV) secondary to chronic central serous chorioretinopathy (CSCR).

Methods

A retrospective database analysis was performed applying the following inclusion criteria: (1) diagnosis of CSCR, (2) diagnosis of secondary CNV, and (3) treatment of at least six consecutive injections of anti-VEGF. Outcome measures included the change of central retinal subfield thickness, remodeling of the pigment epithelium detachments, and change in visual function.

Results

Twenty-one eyes of 21 patients were included. Mean patient age was 65 ± 8.3 years, and 35% of the patients (n = 8) were female. Mean disease duration before diagnosis of CNV was 48 ± 25.3 months. Mean central retinal thickness decreased from 346 ± 61 to 257 ± 57 μm (p < 0.01) after the sixth injection while mean visual acuity improved from 0.65 ± 0.35 to 0.49 ± 0.29 (logMAR; p < 0.01). Of note, an extended upload of six as opposed to three injections yielded an additional mean central retinal thickness reduction (280 ± 46 μm vs. 257 ± 57 μm, p = 0.038). Significant CNV remodeling was observed as a decrease in pigment epithelium detachment (PED) vertical (p = 0.021) and horizontal diameter (p = 0.024) as well as PED height (p < 0.01).

Conclusion

An extended anti-VEGF upload of six consecutive injections seems to be effective in inducing CNV remodeling and fluid resorption in CNV complicating chronic CSCR.

Spaide RF, Campeas L, Haas A, Yannuzzi LA, Fisher YL, Guyer DR, Slakter JS, Sorenson JA, Orlock DA (1996) Central serous chorioretinopathy in younger and older adults. Ophthalmology 103(12):2070–2079 discussion 2079-2080CrossRef

Loo RH, Scott IU, Flynn HW Jr, Gass JD, Murray TG, Lewis ML, Rosenfeld PJ, Smiddy WE (2002) Factors associated with reduced visual acuity during long-term follow-up of patients with idiopathic central serous chorioretinopathy. Retina 22(1):19–24CrossRef

Gallego-Pinazo R, Dolz-Marco R, Gómez-Ulla F, Mrejen S, Freund KB (2014) Pachychoroid diseases of the macula. Medical hypothesis, discovery & innovation ophthalmology journal 3(4):111–115

Pang CE, Freund KB (2015) Pachychoroid neovasculopathy. Retina 35(1):1–9. https://doi.org/10.1097/iae.0000000000000331 CrossRefPubMed

Fung AT, Yannuzzi LA, Freund KB (2012) Type 1 (sub-retinal pigment epithelial) neovascularization in central serous chorioretinopathy masquerading as neovascular age-related macular degeneration. Retina 32(9):1829–1837. https://doi.org/10.1097/IAE.0b013e3182680a66 CrossRefPubMed

de Carlo TE, Rosenblatt A, Goldstein M, Baumal CR, Loewenstein A, Duker JS (2016) Vascularization of irregular retinal pigment epithelial detachments in chronic central serous chorioretinopathy evaluated with OCT angiography. Ophthalmic Surg Lasers Imaging Retina 47(2):128–133. https://doi.org/10.3928/23258160-20160126-05 CrossRefPubMed

Bousquet E, Bonnin S, Mrejen S, Krivosic V, Tadayoni R, Gaudric A (2018) Optical coherence tomography angiography of flat irregular pigment epithelium detachment in chronic central serous chorioretinopathy. Retina 38(3):629–638. https://doi.org/10.1097/iae.0000000000001580 CrossRefPubMed

Mrejen S, Balaratnasingam C, Kaden TR, Bottini A, Dansingani K, Bhavsar KV, Yannuzzi NA, Patel S, Chen KC, Yu S, Stoffels G, Spaide RF, Freund KB, Yannuzzi LA (2019) Long-term visual outcomes and causes of vision loss in chronic central serous chorioretinopathy. Ophthalmology. https://doi.org/10.1016/j.ophtha.2018.12.048

Lai TYY, Staurenghi G, Lanzetta P, Holz FG, Melissa Liew SH, Desset-Brethes S, Staines H, Hykin PG (2018) Efficacy and safety of ranibizumab for the treatment of choroidal neovascularization due to uncommon cause: twelve-month results of the MINERVA study. Retina 38(8):1464–1477. https://doi.org/10.1097/iae.0000000000001744 CrossRefPubMed

10.

Smretschnig E, Hagen S, Glittenberg C, Ristl R, Krebs I, Binder S, Ansari-Shahrezaei S (2016) Intravitreal anti-vascular endothelial growth factor combined with half-fluence photodynamic therapy for choroidal neovascularization in chronic central serous chorioretinopathy. Eye 30(6):805–811. https://doi.org/10.1038/eye.2016.41 CrossRefPubMedPubMedCentral

11.

Peiretti E, Caminiti G, Serra R, Querques L, Pertile R, Querques G (2018) Anti-vascular endothelial growth factor therapy versus photodynamic therapy in the treatment of choroidal neovascularization secondary to central serous chorioretinopathy. Retina 38(8):1526–1532. https://doi.org/10.1097/iae.0000000000001750 CrossRefPubMed

12.

Cheung CMG, Lee WK, Koizumi H, Dansingani K, Lai TYY, Freund KB (2019) Pachychoroid disease. Eye 33(1):14–33. https://doi.org/10.1038/s41433-018-0158-4 CrossRefPubMed

13.

Razavi S, Souied EH, Darvizeh F, Querques G (2015) Assessment of choroidal topographic changes by swept-source optical coherence tomography after intravitreal ranibizumab for exudative age-related macular degeneration. Am J Ophthalmol 160(5):1006–1013. https://doi.org/10.1016/j.ajo.2015.08.009 CrossRefPubMed

14.

Kortum KU, Muller M, Kern C, Babenko A, Mayer WJ, Kampik A, Kreutzer TC, Priglinger S, Hirneiss C (2017) Using electronic health records to build an ophthalmologic data warehouse and visualize patients’ data. Am J Ophthalmol 178:84–93. https://doi.org/10.1016/j.ajo.2017.03.026 CrossRefPubMed

15.

Siedlecki J, Schworm B, Priglinger SG (2019) The pachychoroid disease spectrum-and the need for a uniform classification system. Ophthalmol Retina 3(12):1013–1015. https://doi.org/10.1016/j.oret.2019.08.002 CrossRefPubMed

16.

Dansingani KK, Gal-Or O, Sadda SR, Yannuzzi LA, Freund KB (2018) Understanding aneurysmal type 1 neovascularization (polypoidal choroidal vasculopathy): a lesson in the taxonomy of ‘expanded spectra’-a review. Clin Exp Ophthalmol 46(2):189–200. https://doi.org/10.1111/ceo.13114 CrossRefPubMed

17.

Chhablani J, Kozak I, Pichi F, Chenworth M, Berrocal MH, Bedi R, Singh RP, Wu L, Meyerle C, Casella AM, Mansour A, Bashshur Z, Scorza A, Carrai P, Nucci P, Arevalo JF (2015) Outcomes of treatment of choroidal neovascularization associated with central serous chorioretinopathy with intravitreal antiangiogenic agents. Retina 35(12):2489–2497. https://doi.org/10.1097/iae.0000000000000655 CrossRefPubMed

18.

Matsumoto H, Hiroe T, Morimoto M, Mimura K, Ito A, Akiyama H (2018) Efficacy of treat-and-extend regimen with aflibercept for pachychoroid neovasculopathy and type 1 neovascular age-related macular degeneration. Jpn J Ophthalmol 62(2):144–150. https://doi.org/10.1007/s10384-018-0562-0 CrossRefPubMed

19.

Cho HJ, Jung SH, Cho S, Han JO, Park S, Kim JW (2019) Intravitreal anti-vascular endothelial growth factor treatment for pachychoroid neovasculopathy. J Ocul Pharmacol Ther 35(3):174–181. https://doi.org/10.1089/jop.2018.0107 CrossRefPubMed

20.

Jung BJ, Kim JY, Lee JH, Baek J, Lee K, Lee WK (2019) Intravitreal aflibercept and ranibizumab for pachychoroid neovasculopathy. Sci Rep 9(1):2055. https://doi.org/10.1038/s41598-019-38504-y CrossRefPubMedPubMedCentral

21.

Hata M, Oishi A, Tsujikawa A, Yamashiro K, Miyake M, Ooto S, Tamura H, Nakanishi H, Takahashi A, Yoshikawa M, Yoshimura N (2014) Efficacy of intravitreal injection of aflibercept in neovascular age-related macular degeneration with or without choroidal vascular hyperpermeability. Invest Ophthalmol Vis Sci 55(12):7874–7880. https://doi.org/10.1167/iovs.14-14610 CrossRefPubMed

22.

Julien S, Biesemeier A, Taubitz T, Schraermeyer U (2014) Different effects of intravitreally injected ranibizumab and aflibercept on retinal and choroidal tissues of monkey eyes. Br J Ophthalmol 98(6):813–825. https://doi.org/10.1136/bjophthalmol-2013-304019 CrossRefPubMed

23.

Dansingani KK, Balaratnasingam C, Naysan J, Freund KB (2016) En face imaging of pachychoroid spectrum disorders with swept-source optical coherence tomography. Retina 36(3):499–516. https://doi.org/10.1097/iae.0000000000000742 CrossRefPubMed

24.

Hata M, Yamashiro K, Ooto S, Oishi A, Tamura H, Miyata M, Ueda-Arakawa N, Takahashi A, Tsujikawa A, Yoshimura N (2017) Intraocular vascular endothelial growth factor levels in pachychoroid neovasculopathy and neovascular age-related macular degeneration. Invest Ophthalmol Vis Sci 58(1):292–298. https://doi.org/10.1167/iovs.16-20967 CrossRefPubMed

25.

Terao N, Koizumi H, Kojima K, Yamagishi T, Yamamoto Y, Yoshii K, Kitazawa K, Hiraga A, Toda M, Kinoshita S, Sotozono C, Hamuro J (2018) Distinct aqueous humour cytokine profiles of patients with pachychoroid neovasculopathy and neovascular age-related macular degeneration. Sci Rep 8(1):10520. https://doi.org/10.1038/s41598-018-28484-w CrossRefPubMedPubMedCentral

26.

Terao N, Koizumi H, Kojima K, Yamagishi T, Nagata K, Kitazawa K, Yamamoto Y, Yoshii K, Hiraga A, Toda M, Kinoshita S, Sotozono C, Hamuro J (2018) Association of upregulated angiogenic cytokines with choroidal abnormalities in chronic central serous chorioretinopathy. Invest Ophthalmol Vis Sci 59(15):5924–5931. https://doi.org/10.1167/iovs.18-25517 CrossRefPubMed

27.

Sacconi R, Tomasso L, Corbelli E, Carnevali A, Querques L, Casati S, Bandello F, Querques G (2019) Early response to the treatment of choroidal neovascularization complicating central serous chorioretinopathy: a OCT-angiography study. Eye. https://doi.org/10.1038/s41433-019-0511-2

28.

Spaide RF (2015) Optical coherence tomography angiography signs of vascular abnormalization with antiangiogenic therapy for choroidal neovascularization. Am J Ophthalmol 160(1):6–16. https://doi.org/10.1016/j.ajo.2015.04.012 CrossRefPubMed

29.

Koss MJ, Beger I, Koch FH (2012) Subthreshold diode laser micropulse photocoagulation versus intravitreal injections of bevacizumab in the treatment of central serous chorioretinopathy. Eye 26(2):307–314. https://doi.org/10.1038/eye.2011.282 CrossRefPubMed

30.

Pitcher JD 3rd, Witkin AJ, DeCroos FC, Ho AC (2015) A prospective pilot study of intravitreal aflibercept for the treatment of chronic central serous chorioretinopathy: the CONTAIN study. Br J Ophthalmol 99(6):848–852. https://doi.org/10.1136/bjophthalmol-2014-306018 CrossRefPubMed

31.

Ting DSW, Yanagi Y, Agrawal R, Teo HY, Seen S, Yeo IYS, Mathur R, Chan CM, Lee SY, Wong EYM, Wong D, Wong TY, Cheung GCM (2017) Choroidal remodeling in age-related macular degeneration and polypoidal choroidal vasculopathy: a 12-month prospective study. Sci Rep 7(1):7868. https://doi.org/10.1038/s41598-017-08276-4 CrossRefPubMedPubMedCentral

32.

Lee JH, Lee WK (2016) One-year results of adjunctive photodynamic therapy for type 1 neovascularization associated with thickened choroid. Retina 36(5):889–895. https://doi.org/10.1097/iae.0000000000000809 CrossRefPubMed

33.

Kretz FT, Beger I, Koch F, Nowomiejska K, Auffarth GU, Koss MJ (2015) Randomized clinical trial to compare micropulse photocoagulation versus half-dose verteporfin photodynamic therapy in the treatment of central serous chorioretinopathy. Ophthalmic Surg Lasers Imaging Retina 46(8):837–843. https://doi.org/10.3928/23258160-20150909-08 CrossRefPubMed

34.

van Dijk EHC, Fauser S, Breukink MB, Blanco-Garavito R, Groenewoud JMM, Keunen JEE, Peters PJH, Dijkman G, Souied EH, MacLaren RE, Querques G, Downes SM, Hoyng CB, Boon CJF (2018) Half-dose photodynamic therapy versus high-density subthreshold micropulse laser treatment in patients with chronic central serous chorioretinopathy: the PLACE trial. Ophthalmology 125(10):1547–1555. https://doi.org/10.1016/j.ophtha.2018.04.021 CrossRefPubMed

Title: Response of neovascular central serous chorioretinopathy to an extended upload of anti-VEGF agents
Authors: Benedikt Schworm
Nikolaus Luft
Leonie F. Keidel
Felix Hagenau
Christoph Kern
Tina Herold
Karsten U. Kortuem
Siegfried G. Priglinger
Jakob Siedlecki
Publication date: 01-05-2020
Publisher: Springer Berlin Heidelberg
Keywords: Ranibizumab
Aflibercept
Published in: Graefe's Archive for Clinical and Experimental Ophthalmology / Issue 5/2020
Print ISSN: 0721-832X
Electronic ISSN: 1435-702X
DOI: https://doi.org/10.1007/s00417-020-04623-w

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Response of neovascular central serous chorioretinopathy to an extended upload of anti-VEGF agents

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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