Efficacy and Safety of Intravitreal Aflibercept Injection for Subacute Central Serous Chorioretinopathy
Status:
Completed
Trial end date:
2015-05-01
Target enrollment:
Participant gender:
Summary
Central serous chorioretinopathy (CSC) is a self-limiting disease that usually associated
with good visual prognosis. In some cases, however, CSC may persist and result in permanent
retinal or retinal pigment epithelium (RPE) damage. Therefore, if the disease is persistent
beyond the acute phase, an active treatment should be considered to prevent an irreversible
damage to retinal function.
The pathophysiology of CSC is associated with abnormal choroidal circulation. Indocyanine
green angiography (ICGA) has revealed dilated and congested choroidal vessel and leakage into
the extracellular space that appears as area of hyperfluorescence seen in middle and late
phase in eyes with CSC.
A goal of treatment has been focused on reducing choroidal hyperpermeability. Currently,
photodynamic therapy with verteporfin (PDT) and intravitreal anti-VEGF (vascular endothelial
growth factor)antibody injection are being tried in order to treat chronic CSC. PDT reduces
choroidal hyperpermeability by inducing hypoperfusion of the choriocapillaris in the short
term and choroidal vascular remodeling over time. Intravitreal anti-VEGF injection for the
treatment of CSC also effectively reduces choroidal hyperpermeability by blocking vascular
leakage. Both methods have shown to be effective with good functional outcome for treating
chronic CSC in many reports, but until now there is no established standard treatment
protocol for chronic CSC.
Bevacizumab (Avastin) and ranibizumab (Lucentis) have been used widely as anti-VEGF
therapeutic agent for the treatment of age related macular generation (AMD) and macular edema
of various reasons. A newly developed anti-VEGF drug, aflibercept (Eylea○R), shows higher
affinity to VEGF and has a longer duration of effect in the vitreous.FDA approved aflibercept
to treat wet type AMD and macular edema due to central retinal vein occlusion.
Until now, no study has been reported on the efficacy and safety of aflibercept for treating
CSC. The aim of this study is to evaluate the efficacy and safety of intravitreal aflibercept
injection for the treatment of idiopathic CSC