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Therapieoption bei chronischer Chorioretinopathia centralis serosa

Photodynamische Therapie kombiniert mit Bevacizumab – eine Fallserie

Therapy options for chronic central serous chorioretinopathy

Photodynamic therapy combined with bevacizumab – a case series

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Zusammenfassung

Hintergrund

Wir berichten über die Anwendung der Kombinationstherapie aus photodynamischer Therapie (PDT) und intravitrealer Eingabe von Bevacizumab als Therapieoption bei 9 Patienten mit chronischer Chorioretinopathia centralis serosa (CCS).

Patienten und Methoden

Neun männliche Patienten mit chronischer CCS wurden wie folgt behandelt: Standard PDT-Lasertherapie mit Verteporfin und anschließender intravitrealer Eingabe von Bevacizumab innerhalb von 24 h. Präoperativ sowie 1, 3, 6, 9 und 12 Monate postoperativ wurden Visus, Fluoreszenzangiographie (FLA) und optische Kohärenztomographie (OCT) dokumentiert.

Ergebnisse

Bei allen Patienten kam es zu einer Verbesserung der Sehschärfe von 1–4 ETDRS-Zeilen. Der mittlere Visus stieg von 0,5 präoperativ auf 0,8 postoperativ nach 3 Monaten. FLA und OCT zeigten in allen Fällen eine Rückbildung der Leckagen und der subretinalen Flüssigkeit. Die Verlaufsbeobachtung von 8 Patienten über 9–12 Monate ergab einen stabilen Visus ohne CCS-Rezidiv.

Schlussfolgerung

PDT kombiniert mit Bevacizumab zeigt sich in unserer Fallserie als wirkungsvolle und sichere Kombinationstherapie, die als Therapieoption für Patienten mit chronischer CCS ohne Besserungstendenz geeignet ist.

Abstract

Background

This article reports about the use of a combined photodynamic therapy (PDT) and intravitreal injection of bevacizumab as a treatment option in nine patients with chronic central serous chorioretinopathy (CSC).

Patients and methods

A total of nine male patients with chronic CSC were treated with standard PDT laser treatment with verteporfin and intravitreal injection of bevacizumab administered within 24 h. Before and 1, 3, 6, 9 and 12 months after treatment the results of visual acuity, fluorescein angiography (FA) and optical coherence tomography (OCT) examinations were documented.

Results

All patients showed an improvement in visual acuity of 1–4 ETDRS lines. Mean visual acuity increased from baseline 20 / 40 to 20 / 25 after 3 months. FA and OCT findings showed a restitution of leakages and subretinal fluid in all cases. After 6–12 months follow-up 8 patients had ongoing improvement in vision without recurrence of CSC.

Conclusion

The combination of PDT with bevacizumab in this case series appears to be an effective and safe therapy combination which is suitable as a therapeutic option for patients with chronic CCS without a tendency to recovery.

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Authors and Affiliations

  1. Klinik und Poliklinik für Augenheilkunde, Klinikum rechts der Isar der Technischen Universität München, Ismaninger Str. 22, 81675, München, Deutschland

    M. Maier, V. Valet, N. Feucht & C.P. Lohmann

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  1. M. Maier
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  2. V. Valet
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  4. C.P. Lohmann
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Correspondence to M. Maier.

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Maier, M., Valet, V., Feucht, N. et al. Therapieoption bei chronischer Chorioretinopathia centralis serosa. Ophthalmologe 108, 1027–1031 (2011). https://doi.org/10.1007/s00347-011-2419-5

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