Efficacy and Safety of Intravitreal Aflibercept Injection for Subacute Central Serous Chorioretinopathy

Sponsor
Asan Medical Center
Study ID
NCT01971190
Phase
PHASE2
Status
Completed

Conditions

  • Central Serous Chorioretinopathy

Eligibility Criteria

Sex
ALL
Age
18 Years - 60 Years
Healthy Volunteers
Not accepted

Interventions

  • Intravitreal Aflibercept injection — DRUG
    2mg intravitreal Aflibercept(Eylea) injection at baseline, at 1 month, and at 2 month. At 3 month, 4 month, 5 month, and 6 month, PRN treatment of aflibercept injection or half-fluence photodynamic therapy may be done, if one of following conditions is fulfilled. The PRN treatment method was decided by investigator's discretion. Of patient who had persistent intra- or subretina fluid on SD-OCT 1. Central subfield thickness is not decreased to more than 50 micrometer compared with baseline central subfield thickness 2. Best-corrected ETDRS letter score dose not increased more than 5 letters than baseline (because of the persistent CSC). 3. Central subfield thickness is thicker than the previous exam 4. BCVA letter score is worse than the previous exam (because of the persistent CSC)
  • Sham injection — DRUG
    Sham injection at baseline, at 1 month, and at 2 month. At 3 month, 4 month, 5 month, and 6 month, PRN treatment of aflibercept injection or half-fluence photodynamic therapy may be done, if one of following conditions is fulfilled. The PRN treatment method was decided by investigator's discretion. Of patient who had persistent intra- or subretina fluid on SD-OCT 1. Central subfield thickness is not decreased to more than 50 micrometer compared with baseline central subfield thickness 2. Best-corrected ETDRS letter score dose not increased more than 5 letters than baseline (because of the persistent CSC). 3. Central subfield thickness is thicker than the previous exam 4. BCVA letter score is worse than the previous exam (because of the persistent CSC)
  • Half-fluence photodynamic therapy — PROCEDURE
    At 3 month, 4 month, 5 month, and 6 month, PRN treatment of aflibercept injection or half-fluence photodynamic therapy may be done, if one of following conditions is fulfilled. The PRN treatment method was decided by investigator's discretion. Of patient who had persistent intra- or subretina fluid on SD-OCT 1. Central subfield thickness is not decreased to more than 50 micrometer compared with baseline central subfield thickness 2. Best-corrected ETDRS letter score dose not increased more than 5 letters than baseline (because of the persistent CSC). 3. Central subfield thickness is thicker than the previous exam 4. BCVA letter score is worse than the previous exam (because of the persistent CSC)

Study Details

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

Key Dates

Start date
Oct 31, 2013
Status verified
Jun 2015
Primary completion
Apr 30, 2015
Completion
May 31, 2015

Study Design

Enrollment
43 participants (actual)
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT

Arms

  • Sham Comparator: Sham injection
    Sham injection at baseline, at 1 month, and at 2 month
  • Active Comparator: Intravitreal Aflibercept injection
    2mg intravitreal Aflibercept(Eylea) injection at baseline, at 1 month, and at 2 month

Primary Outcome Measure

Changes of central subfield thickness from baseline with time [ Time Frame: at 1,2,3,4,5,6 month ]

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