Efficacy of Intravitreal Bevacizumab in Chronic Central Serous Chorioretinopathy in Terms of Mean Reduction of Central Macular Thickness in Pakistani Patients

Abstract

Background: Central serous chorioretinopathy (CSCR) is an idiopathic condition described by serous neurosensory retinal detachment at the posterior pole, usually associated with serous retinal pigment epithelial detachment (PED). CSCR patients as a rule have good visual prognosis. In most of the patients, CSCR is self-limiting and patients regain the last visual acuity. However, some patients may have visual disability due to permanent RPE and photoreceptor damage. Objective: The objective of the study is to determine the effect of intravitreal Bevacizumab in cases of chronic central serous chorioretinopathy in terms of mean change in central macular thickness. Study Design: Interventional experimental study. Settings: The study was conducted in Department of Ophthalmology, Allied Hospital, Faisalabad Pakistan. Duration: 2 years from January 2017 to December 2018. Methodology: An aggregate of 95 cases were recruited for the study. Study included both male and female patients with diagnosis of chronic CSCR (at least 6month duration). Best corrected visual acuity, Intra Ocular Pressure on Goldman applanation Tonometer and Optical coherence tomography on Optovue were recorded of both eye of all patients. Before starting the treatment, informed consent was signed by every patient and they were called on the day of injection. Intravitreal off label Bevacizumab (1.25/0.05ml) was given through pars plana in operation theater under aseptic conditions. After injection topical antibiotic drops were given to patients for one week and patients called for follow up after one week, one month, 2 month and 3 months. Same parameters BCVA, IOP, Dilated fundus examine and OCT was recorded on every visit. The final outcome i.e., change in central macular thickness was recorded. Results: In this study, out of 95 cases, 53.68%(n=51) were between 30-45 years of age while 46.32%(n=44) were between 46-60 years of age, mean ± SD was calculated as 46.83+7.82 years, 74.74%(n=71) were male and 25.26%(n=24) were females. Pre-treatment mean central macular thickness was recorded as 344.77+14.61µ which reduced to 154.57+16.57 µ, mean difference was recorded as 190.2+21.46 µ, p value was 0.0001 showing a significant difference. Conclusion: We concluded that intravitreal Bevacizumab significantly reduced central macular thickness in cases of chronic central serous chorioretinopathy.