Efficacy and Safety of Intravitreal Brolucizumab in Chronic Central Serous Chorioretinopathy: A Retrospective Cohort Study.

Purpose: To evaluate the anatomical and functional outcomes and treatment burden of intravitreal brolucizumab in chronic central serous chorioretinopathy (cCSCR) over 12 months in a real-world setting.

Patients and methods: In this retrospective, single-center cohort, 29 eyes with cCSCR received pro re nata intravitreal brolucizumab. Baseline OCT angiography excluded macular neovascularization. Patients were seen monthly for three months, then as needed through month 12. At each visit, best-corrected visual acuity (BCVA), central retinal thickness (CRT), and presence of SRF, intraretinal fluid (IRF), and pigment epithelium detachment (PED; including PED height) were recorded. Total injections per eye were tallied.

Results: Twenty-nine eyes (mean age 55.2±11.0 years; 72% male) with cCSCR received 1.72 ± 0.62 intravitreal brolucizumab injections over 12 months. Vision improved from BCVA 0.59 ± 0.23 logMAR at baseline to 0.46 ± 0.22 at one month (P=0.002), 0.40 ± 0.20 at three months (P<0.001), and 0.39 ± 0.20 at month 12 (P<0.001). Mean CRT reduced from 340 ± 140 µm to 260 ± 110 µm at one month and stabilized at 230 ± 98 µm by month 12 (P<0.001). Mean PED height decreased from 48 ± 55 µm at baseline to 13 ± 17 µm at month 12 (P<0.001). Fluid resolution was rapid and sustained; SRF cleared in 63% at one month (P<0.001) and 88.9% at 12 months (P<0.001), IRF in 85.7% by month 3 (P=0.016) and 71.4% by month 12 (P=0.063), and PEDs in 43.8% at one month (P=0.021) rising to 68.8% at month 12 (P=0.001). No ocular or systemic adverse events occurred.

Conclusion: Intravitreal brolucizumab provided significant and sustained visual and anatomical improvements in cCSCR with a low injection burden over 12 months. Given the off‑label use and absence of a control group, findings should be interpreted cautiously and confirmed in prospective controlled studies.