| 본문 : Purpose: To report a case of atypical healing process in central serous chorioretinopathy(CSC) patient treated with intravitreal bevacizumab injection that was corrected with photodynamic therapy.
Case summary: A 38-year-old man had been experiencing central scotoma in his right eye for about a week. He had a history of central serous chorioretinopathy in his right eye about 6 months ago. At the initial visit, corrected visual acuity of the right eye was 0.8 and that of the left eye was 1.0. Funduscopic examination showed 3 disc diameter sized subfoveal serous subretinal fluid in the right eye. Fluorescein angiography(FAG), indocyanine green angiography(ICG), and optical coherence tomography(OCT) were performed on both eyes. FAG showed single discrete leakage point that evenly distributed dye through the subretinal fluid, and ICG showed choroidal hyperpermeability in the mid-to-late phase. OCT showed 2 disc diameter sized subretinal fluid. After 2months of observation, the patient still complained about central scotoma with deteriorated vision to 0.6. Intravitreal bevacizumab injection was administered. 1 month later, OCT showed inner retinal rolling with macular cyst with persistent subretinal fluid. Visual acuity was 0.6. 2months later, OCT finding was same with that of 1month’s follow up. Photodynamic therapy was done on right eye. About 6 weeks later, inner retinal rolling with macular cyst disappeared on OCT, and visual acuity also improved to 1.0.
Conclusions: One-third to one-half of CSC cases will recur, and nearly 50 percent recur within 1 year of the initial event. In recurrent case, early treatment has been recommended. Intravitreal bevacizumab injection could be done in CSC, but as reported, it could cause atypical course of healing. Photodynamic therapy could be more safe and efficient treatment for recurrent CSC.
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