{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T18:29:35Z","timestamp":1793730575267,"version":"4.6.1"},"reference-count":29,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","license":[{"start":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T00:00:00Z","timestamp":1779840000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,6]]},"abstract":"\n Purpose:<\/jats:title>\n To assess the long-term safety and efficacy of intravitreal brolucizumab (Pagenax\u00ae) in eyes with chronic central serous chorioretinopathy (CSC) complicated by neovascularization (pachychoroid neovasculopathy) refractory to prior therapies.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n In this single-center retrospective case series (January 2021\u2013July 2025), 30 eyes of 25 patients with recalcitrant and refractory cases of chronic CSC with secondary neovascularization were treated off-label with pro-re-nata intravitreal brolucizumab. Best-corrected visual acuity (BCVA), central subfield thickness (CST), and pigment epithelial detachment (PED) height were measured at baseline and 6 months, with extended outcomes in nine eyes assessed at 1 and 2 years. Adverse events were recorded at each visit.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n At 6 months, the mean CST decreased significantly from 328 \u00b1 222 \u00b5m to 172 \u00b1 79 \u00b5m (\n P<\/jats:italic>\n < 0.001), and the PED height declined from 262 \u00b1 192 \u00b5m to 155 \u00b1 123 \u00b5m (\n P<\/jats:italic>\n = 0.027). BCVA improved or remained stable in 90% of eyes, with no significant change in mean logMAR (0.38 to 0.33,\n P<\/jats:italic>\n = 0.314). In the extended cohort, CST reductions persisted at 1 year (412 \u00b1 241 \u00b5m to 271 \u00b1 239 \u00b5m,\n P<\/jats:italic>\n = 0.009) and 2 years (412 \u00b1 241 \u00b5m to 164 \u00b1 42 \u00b5m,\n P<\/jats:italic>\n = 0.004), while BCVA stayed stable. A weak correlation suggested more injections might be linked to slightly poorer BCVA, possibly due to resistant cases requiring more treatment. No adverse events were noted.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n Intravitreal brolucizumab administered PRN effectively resolves persistent fluid and reduces PED in chronic CSC with PNV refractory to prior treatments, while maintaining stable visual acuity and demonstrating a favorable safety profile through 2 years of follow-up.<\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/ijo.ijo_2032_25","type":"journal-article","created":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T05:00:27Z","timestamp":1779858027000},"page":"893-900","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Long-term analysis of intravitreal brolucizumab in recalcitrant cases of chronic central serous retinopathy complicated by neovascularization (pachychoroid neovasculopathy)"],"prefix":"10.4103","volume":"74","author":[{"given":"Lalit","family":"Verma","sequence":"first","affiliation":[{"name":"Department of Vitreo-retina Services, Centre for Sight, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shweta","family":"Singh","sequence":"additional","affiliation":[{"name":"Department of Vitreo-retina Services, Centre for Sight, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dinesh","family":"Talwar","sequence":"additional","affiliation":[{"name":"Department of Vitreo-retina Services, Centre for Sight, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Avnindra","family":"Gupta","sequence":"additional","affiliation":[{"name":"Department of Vitreo-retina Services, Centre for Sight, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gauri","family":"Khare","sequence":"additional","affiliation":[{"name":"Department of Vitreo-retina Services, Centre for Sight, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Obuli N","family":"Ramachandran","sequence":"additional","affiliation":[{"name":"Department of Vitreo-retina Services, Centre for Sight, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"family":"Bhanupriya","sequence":"additional","affiliation":[{"name":"Department of Vitreo-retina Services, Centre for Sight, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gaganjeet Singh","family":"Gujral","sequence":"additional","affiliation":[{"name":"Department of Vitreo-retina Services, Centre for Sight, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H S","family":"Harish","sequence":"additional","affiliation":[{"name":"Department of Vitreo-retina Services, Centre for Sight, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikita","family":"Gupta","sequence":"additional","affiliation":[{"name":"Department of Vitreo-retina Services, Centre for Sight, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,5,27]]},"reference":[{"key":"R1-20261103","doi-asserted-by":"crossref","first-page":"1659","DOI":"10.1097\/IAE.0b013e3182953df4","article-title":"Pachychoroid pigment epitheliopathy","volume":"33","author":"Warrow","year":"2013","journal-title":"Retina"},{"key":"R2-20261103","doi-asserted-by":"crossref","first-page":"499","DOI":"10.1097\/IAE.0000000000000742","article-title":"EN face imaging of pachychoroid spectrum disorders with swept-source optical coherence tomography","volume":"36","author":"Dansingani","year":"2016","journal-title":"Retina"},{"key":"R3-20261103","doi-asserted-by":"crossref","first-page":"819","DOI":"10.1038\/s41433-024-03253-4","article-title":"Pachychoroid disease: Review and update","volume":"39","author":"Cheung","year":"2025","journal-title":"Eye 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ARI","volume":"281","author":"Sasaki","year":"2026","journal-title":"Am J Ophthalmol"},{"key":"R16-20261103","doi-asserted-by":"crossref","first-page":"212","DOI":"10.18502\/jovr.v18i2.13188","article-title":"Pachychoroid spectrum disorders: An updated review","volume":"18","author":"B Brown","year":"2023","journal-title":"J Ophthalmic Vis Res"},{"key":"R17-20261103","doi-asserted-by":"crossref","first-page":"7379","DOI":"10.1038\/s41598-023-33936-z","article-title":"Pachychoroid neovasculopathy has clinical properties that differ from conventional neovascular age-related macular degeneration","volume":"13","author":"Kuranami","year":"2023","journal-title":"Sci Rep"},{"key":"R18-20261103","first-page":"3528","article-title":"Current diagnosis and management strategies in pachychoroid spectrum of diseases (Review)","volume":"20","author":"Moraru","year":"2020","journal-title":"Exp Ther Med"},{"key":"R19-20261103","doi-asserted-by":"crossref","first-page":"304","DOI":"10.3341\/kjo.2024.0020","article-title":"Pachychoroid spectrum disease: Comparison of patients with central serous chorioretinopathy complicated with pachychoroid neovasculopathy","volume":"38","author":"Jung","year":"2024","journal-title":"Korean J Ophthalmol"},{"key":"R20-20261103","doi-asserted-by":"crossref","first-page":"2489","DOI":"10.1097\/IAE.0000000000000655","article-title":"Outcomes of treatment of choroidal neovascularization associated with central serous chorioretinopathy with intravitreal antiangiogenic agents","volume":"35","author":"Chhablani","year":"2015","journal-title":"Retina"},{"key":"R21-20261103","doi-asserted-by":"crossref","first-page":"1464","DOI":"10.1097\/IAE.0000000000001744","article-title":"Efficacy and safety of ranibizumab for the treatment of choroidal neovascularization due to uncommon cause: Twelve-month results of the MINERVA 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History"}},{"value":"2026-04-06","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}