Avastin Central serous retinopathy '' CSR''

[Johnny852]

I had an avastin my first avastin (bevacizumab) injection for my eye on october 30 th 2009 , the doctor had monitered my CSR for 1 year and it did not resolve by itself , he told me that I had type 2 CSR , meaning that I had leakeage in between the choroid and the RPE , my next appointment will be on december 3rd 2009 , the ophtalmalogist will take an OCt scan and compare it with the one done on september 2009 to see if there is any improvement ?
I have seen improvements but they are fluctuating  ? meaning in the morning i am seeing very clear with minimal distortion and in the evening I am seeing distorted , i have noticed that visual acuity has improved ... How long does it take for the avastin to seal the leaks that are present at the choroids ?
Does avastin offer a real  prognosis of success  for the elimination of the serous detachement in my case it is only a pigment epetalial detachement type 2 CSR . How much time will it take before i get rid of this blister in my eye ???

[Johnny852]

Dear Doctor thank you for answering my question , My doctor Jean Deschesne of the Royal Victoria Hospital Mcgill University center , has told me that Avastin should work the remove the blister I have had no new recurrence since one year .
He also has offered to use PDT a cold laser treatment ... should the avastin not work?
I have had an FA done and it is very irregular it has petaloid  formation.
I don't have this problem in the other eye , You have told me that PED  are also found in  Age related macular degeneration ?
Is there something I should know ?
does my problem seem to be linked to CSR or is it something really worst .? What is the probability of the leak to stop and  full reabsorbing ?
I can forward you the angiogram and the previous OCT and the next OCt by e-mail
Should you accept I am ready to send them to you the PED is 2/3 the size of the optic disk  before the treatment it was 3/4 the size .
What are the chances of avastin or Photodynamic therapy working on me ?
I have taken time off from work but Do you think that it is work related caused by stress ?

The retinal specialist told me that conventional laser will not be used as it is very close to the fovea encroaching on the fovea , he has suggested a step ladder approach .
First Avastin second. PDT , he has told me that to observe is not a form of treatment as degenerative changes might occur ?
my vision is presently 20/20 in both eyes , I have faith in my doctors John Chen  and doctor Jean Deschesnes  of the Royal Victoria  Hospital  Mcgill university Center  Montreal Canada .

Should you decide to answer me or want to receive copies of FA and OCT by e-mail send me your e-mail adress and I will respond .

johnny.***@****

[Ray T Oyakawa, MD]

Avastin does not work well with Pigment epithelial detachment (PED) for age related macular degeneration.  It will remove the subretinal fluid.  However, we use it since there are no good alternatives and it helps in some cases.

CSR PED can also be treated with laser if not close to fovea.  I do not have much experience in Avastin for CSR.

I believe there is a stress factor and I have asked my  patients to take time off work or do something to relieve stress.

I have seen many case over the past 25 years and I believe I have only treated two or three.   The other problem with CSR is that it frequently recurs in other areas.

I am currently following a CSR patient who make sets for movies and has 12 to 14 hour days.  I have  not treated and have been following him for about one year.  His vision fluctuates.

Dr.O.