Efficacy of Intravitreal Brolucizumab for Chronic Central Serous Chorioretinopathy: A Pilot Study

Background/Objectives: Chronic central serous chorioretinopathy (cCSC) is a vision-threatening disorder characterized by persistent subretinal fluid (SRF). While several treatment options exist, their efficacy varies, and optimal management remains uncertain. This retrospective pilot study aimed to evaluate the efficacy and safety of intravitreal brolucizumab in patients with symptomatic cCSC without pachychoroid neovasculopathy (PNV). Methods: In total, 15 eyes of 15 patients diagnosed with symptomatic cCSC without PNV were treated with a single intravitreal injection of brolucizumab. Patients were followed for six months. Primary outcomes included resolution of SRF and changes in central subfield thickness (CST) and subfoveal choroidal thickness (SCT). Best-corrected visual acuity (BCVA) and ocular safety profiles were also assessed. Results: Complete SRF resolution was observed in 14 of 15 eyes (93.3%) within six months. Mean CST significantly decreased from 317.13 ± 73.40 µm to 205.53 ± 20.17 µm (p < 0.001), and mean SCT from 475.87 ± 107.66 µm to 390.13 ± 121.67 µm (p < 0.001). BCVA improved in 12 eyes (80.0%) and remained stable in 3 eyes; however, the mean improvement (logMAR 0.34 ± 0.33 to 0.14 ± 0.13) was statistically significant (p = 0.007). No significant ocular adverse events were reported. Conclusions: Intravitreal brolucizumab may be an effective and safe treatment for reducing SRF and choroidal thickness in patients with cCSC without PNV. Larger, controlled studies are needed to validate these findings.