AIM: To observe the efficacy of intravitreal anti-vascular endothelial growth factor(VEGF)injection treatment in chronic central serous chorioretinopathy(CCSC)combined with choroidal neovascularization(CNV)using multimodal imaging, to explore and evaluate the influence factors.

METHODS: In this retrospective study, 30 patients(30 eyes)were diagnosed as CCSC combined with CNV. Comprehensive ophthalmologic examinations were performed, including best corrected visual acuity(BCVA), enhanced-depth imaging(EDI)spectral domain optical coherence tomography(SD-OCT), fundus fluorescein angiography(FFA), Indocyanine green angiography(ICGA), and optical coherence tomography angiography(OCTA). Patients were treated with intravitreal ranibizumab(IVR)parallel 1+PRN schem for subretinal fluid(SRF)secondary to CCSC combined with CNV. All the patients were followed up at 1wk, 1mo after treatment and 3mo after consecutive treatment. The BCVA, central macular thickness(CMT), subfoveal choroid thickness(SFCT)and CNV flow area were compared.

RESULTS: All the patients were observed at baseline, 1wk, 1mo after treatment and 3mo after consecutive treatment. The difference at various time points of CMT(μm)were statistically significant(F=62.06, P<0.01). CMT after treatment at each time point was compared with baseline, the difference among each time points was statistically significant(t=3.08, 6.57, 4.90; P=0.01, 0.02, <0.01). In which 46.7% of patients, SRF can be completely absorbed(14/30). The difference at various time points of BCVA(LogMAR)were statistically significant(F=87.21, P<0.01). BCVA after treatment at each time point was compared with baseline, the difference between each group was statistically significant(t=6.52, 4.71, 6.01; P=0.03, <0.01, <0.01). The difference at various time points of SFCT(μm)were statistically significant(F=57.98, P<0.01). SFCT after treatment at each time point was compared with baseline, the difference among each time points was statistically significant(t=5.11, 9.03, 4.2; P=0.03, <0.01, <0.01). The difference at various time points of CNV area(mm²)were statistically significant(F=70.78, P<0.01). CNV area at 1wk and 1mo after treatment was compared with baseline, the difference was no statistically significant(t=7.01, 6.54; P=0.07, 0.05). CNV area at 3mo after the last treatment was compared with baseline, the difference was statistically significant(t=4.51, P=0.02). The change of CMT was positively correlated with the baseline CMT, BCVA and CNV area(r=0.43, 0.41, 0.41; P=0.02, 0.03, 0.03). The change of BCVA was positively correlated with the baseline BCVA and CMT(r=0.89, 0.43; P<0.01, 0.02).

CONCLUSION: CCSC combined with CNV show different sensitivity to anti-VEGF therapy, the SRF can be completely absorbed after treatment in parts of patients. CNV may not be the only predictive factor leading to the SRF. The baseline BCVA, CMT and CNV area may be the factors that influence the final therapeutic effect of the intravitreal anti-VEGF injection therapy.