ABSTRACT

Title : Anti VEGF as Monotherapy Central Serous Chorioretinopathy

Author : Ni Kadek Puspa Mega Putri Sudibia; Andayani, Ari
Ophthalmology Department, Faculty of Medicine
Udayana University, Sanglah Hospital, Denpasar

Introduction
Central Serous Chorioretinopathy (CSCR) is a retinal disorder that is clinically characterized
by detachment of the neurosensory retina to the macula. Anti VEGF is a therapeutic modality
for CSCR. The use of anti-VEGF has a resolution effect of subretinal fluid which causes a
decrease in the hyperpermeability of the choroid after anti-VEGF measures.

Cases
The first case, a 39-year-old man complained of blurred left eye vision since 1 month ago,
sharp right and left eye vision 6/6. Patients also complained about seeing objects smaller than
the actual size when viewed with the right eye. Patients with high stress are categorized as
personality type A. In OCT, there is a picture of serous area and serous detachment in the
macular area as well as a double layer image. The patient was diagnosed with CSCR + PED
dd / PCV left eye and received artificial tears 6x1 therapy in the left eye. Anti VEGF
injection was carried out on 26 August 2020 and 1 month after injection, 6/6 visual acuity
was obtained and the OCT image was normal.

The second case, a 39-year-old woman complained of blurred right eye vision since early
August 2020. Blurred vision is felt to be unable to see clearly in the middle area. The visual
acuity in the right eye was 6/12 PH NI and the left eye was 6/6. The patient has a history of
smoking. The stressful patient is categorized as type A personality. The patient was
diagnosed with CSCR + PED right eye. and received artificial tears therapy 6x1 in the right
eye. Anti VEGF injection was carried out on September 8, 2020 and 1 month after injection,
visual acuity improved to 6 / 7.5 PH 6/6 and the OCT picture returned to normal.

The third case, a 39 year old man, complained of blurred right eye vision since the end of
July 2020. Blurred vision is felt to be unable to see clearly in the middle area. The visual
acuity in the right eye was 6/30 PH 6/12 and the left eye 6/21 PH 6 / 7.5. The stressful patient
is categorized as type A personality. The patient was diagnosed with CSCR right eye. and
received artificial tears therapy 6x1 in the right eye. Anti VEGF injection was carried out on
November 11, 2020 and 1 month after injection, visual acuity improved to 6 / 7.5 PH 6/6 and
the OCT picture returned to normal.

The fourth case, a 35-year-old man complained of blurred right eye vision since late
September. Blurred right eye vision is felt to be unable to see clearly in the middle area. The
visual acuity in the right eye was 6/45 PH 6/21 and the left eye was 6/21 PH NI. The patient
has a history of smoking. Patient was diagnosed with CSCR right eye and left eye amblyopia
+ hypermetropia and received artificial tears therapy 6x1 right left eye. Anti VEGF injection
was carried out on October 20, 2020 and 1 month after injection, it was found that visual
acuity improved to 6/30 PH 6/18 and the OCT picture returned to normal.

Discussion

Various management can be done for CSCR cases. The right treatment options can prevent
irreversible damage to the RPE so that sharp eyesight cannot return to normal. This case
demonstrates the choice of anti-VEGF treatment as monotherapy from CSCR which is able to
provide good visual acuity resolution results and post-procedure OCT.

Keywords:

CSCR, Central serous chorioretinopathy, Anti VEGF