Case Study

Central Serous Retinopathy | Anti-VEGF Therapy

Central serous chorioretinopathy, commonly known as CSCR is a disease in which a serous detachment of the neurosensory retina occurs over an area of leakage from the choriocapillaris through the retinal pigment epithelium (RPE).

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What is CSR?

Central serous chorioretinopathy, commonly known as CSCR is a disease in which a serous detachment of the neurosensory retina occurs over an area of leakage from the choriocapillaris through the retinal pigment epithelium (RPE).

It is a self-limited macular disease marked by distortion, blurry vision, and metamorphopsia. Other causes for RPE leaks, such as choroidal neovascularization, inflammation, or tumors, should be ruled out to reach a diagnosis. Choroidal neovascularization is also an uncommon complication of CSCR.

It is the fourth most common retinopathy after age-related macular degeneration, diabetic retinopathy, and branch retinal vein occlusion.

What is Anti-VEGF Therapy?

Vascular endothelial growth factor (VEGF) is a protein that promotes the growth of new blood vessels. It also makes the blood vessels more prone to leaks Anti-VEGF medicines stop the abnormal blood vessels leaking, growing, and then bleeding under the retina. In ophthalmology, the most common application of Anti-VEGF medicines is for treatment of age-related macular degeneration and diabetic retinopathy with macular edema.

Patient Case of Malignant form of CSR

Patient M, 39 years old, applied to the Ophthalmological Department of FUH with complaints of a slight deterioration in vision, micropsia, metamorphopsia, hyperopic shift. The examination revealed a significant separation of the layers of the retina in the macular region of the left eye, which is characteristic of Central Serous Retinopathy.

Conventional Treatment

The prescribed conventional treatment did not bring the desired effect. Significant decrease in visual acuity to 20/200 and a dramatic increase in edema in the macular area of the retina was revealed in patient’s visit 1 week later.

Anti-VEGF Intravitreal Injection

Given the malignant course of the disease, the progressive deterioration of visual functions and anatomical parameters of the eye, it was decided to use a more aggressive treatment plan such as Intravitreal Injection Anti-VEGF medicine (Aflibercept) 40 mg.

Immediate Rresult

Follow-up examination of the patient, three days after the procedure, revealed a significant improvement in vision and a decrease in the separation of retinal layers. This trend continued and the function of the eye was fully restored 7 days after the procedure. The effect of the treatment was noticed to be persistent during 3 months of follow up.

The use of Anti-VEGF intravitreal injection for treatment of Central serous retinopathy is recognized as effective and reasonable.

Dr. Vladimir Tchouprine

Specialist Ophthalmology
Fakeeh University Hospital

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