2M.D. Islahiye State Hospital, Department of Ophthalmology, Gaziantep/TURKEY
3M.D. Professor, Ankara University Faculty of Medicine, Department of Ophthalmology Ankara/TURKEY Purpose: To evaluate the therapeutic efficacy of intravitreal ranibizumab injection in patients with chronic central serous chorioretinopathy (CSC) and the effect of outer segment integrity on visual acuity after treatment.
Material and Methods: The records of patients with chronic CSC who were treated with intravitreal ranibizumab were reviewed. The baseline and follow-up examinations included best corrected visual acuity (BCVA) and spectral domain optical coherence tomography (OCT). The main outcome measures were the changes in BCVA and central macular thickness (CMT) between the baseline and follow-up examinations.
Results: Twenty-eight eyes of 25 patients were retrospectively analyzed. The mean follow-up period was 11.5 months. The mean preinjection BCVA was 0.31 logMAR (range 0-1.8) and improved to 0.19, 0.26 and 0.22 logMAR at the 3rd month, 6th month, and at the final visit (p=0.014), respectively. The mean CMT was 315 μm (range 185-607) at baseline and regressed to 218, 208 and 199 μm in the 3rd month, 6th month, and on the final visit, respectively. There was a significant difference between baseline and all follow-up measurements (p<0.001). However, a direct correlation was not detected between anatomic improvement and visual recovery. The defects of ISOS (p=0.001) and ELM (p=0.008) were significantly related to poor visual outcome.
Conclusion: Although, intravitreal ranibizumab injection was used as an alternative treatment method for treating patients with chronic CSC, nearly half of the patients were refractory to treatment and most of the others needed re-injections. It doesn't seem to be an ideal treatment for chronic CSCR.
Keywords : Central serous chorioretinopathy, eksternal limiting membrane, optical coherence tomography, outer photoreceptor layer, ranibizumab