Search

Central serous chorioretinopathy (CSC) is a prevalent exudative maculopathy and the ongoing verteporfin shortage restricts current treatment possibilities. Topical non‐steroidal anti‐inflammatory drugs (NSAID) have previously been proposed as a treatment for CSC, although its exact efficacy remains unclear. In this systematic review and meta‐analysis, we outlined the efficacy of topical NSAIDs for the treatment of CSC. We searched 11 literature databases on 13 December 2022, for any study describing topical NSAID treatment for CSC. Thirteen eligible studies were included with a total of 1001 eyes of 994 patients with CSC. Six studies were case reports, two were cohort studies and five were non‐randomized comparative studies. Where specified, topical NSAIDs used were bromfenac 0.09%, diclofenac 0.1%, ketorolac 0.4% and 0.5%, pranoprofen 0.1%, and nepafenac 0.1% and 0.3%. Studies were predominantly of cases with acute CSC and several case studies reported treatment outcomes simultaneously with discontinuation of corticosteroid use, which complicated treatment evaluation. Meta‐analyses of comparative studies revealed a statistically significant but clinically irrelevant best‐corrected visual acuity improvement of −0.04 logMAR (95% CI: −0.07 to −0.01 logMAR; p = 0.01) at 1‐month follow‐up, which became statistically insignificant at 3‐month follow‐up (−0.03 logMAR; 95% CI: −0.06 to 0.003 logMAR; p = 0.08). Further, we found no benefit in complete subretinal fluid resolution at 1‐month follow‐up (OR: 1.20; 95% CI: 0.81–1.76; p = 0.37) or 3‐month follow‐up (OR: 1.17; 95% CI: 0.86 to 1.59; p = 0.33). Taken together, available evidence does not support the use of topical NSAIDs for the treatment of CSC. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of the study was to evaluate temporal changes in age‐ and sex‐stratified incidence rates of retinal vein occlusion (RVO) commenced in anti‐vascular endothelial growth factor (anti‐VEGF) treatment, proportion of patients remaining in active anti‐VEGF therapy over time, and to develop a forecasting model for future number of patients with RVO in active anti‐VEGF therapy. Methods: This was a registry‐based study of patients with RVO in the Capital Region of Denmark from commenced in anti‐VEGF therapy from 1 January 2007 to 30 June 2022. Census data were extracted from Statistics Denmark for incidence rate analyses and forecasting data of future demographics. Results: A total of 2641 patients with RVO were commenced in anti‐VEGF therapy, of which 2192 were later discontinued. Number of patients rose dramatically during the first years of introduction of anti‐VEGF therapy, after which growth was slower and followed the demographic changes. Trend analyses revealed that the COVID‐19 epidemics impacted with fewer referrals and more aggressive discontinuation practices. Annual incidence of RVO in 2012–2021 was 13.1 per 100 000 (95% CI: 12.6–13.6 per 100 000). Proportion of patients with RVO remaining in active anti‐VEGF treatment was 55.0%, 40.1%, 30.8% and 12.1% after Years 1, 2, 3 and 8, respectively. According to our forecast, number of patients with RVO in active anti‐VEGF therapy will grow slowly but continually at least until year 2035. Conclusion: Our study reports incidence rates and provides prognostic modelling of number of patients with RVO in anti‐VEGF therapy. [ABSTRACT FROM AUTHOR]