Effect of Ginkgo biloba Extract on Anti-vascular Endothelial Growth Factor Treatment Requirement and Chronicity in Acute Central Serous Chorioretinopathy: A Multicenter Retrospective Study

Purpose: To evaluate whether oral Ginkgo biloba extract (GBE) is associated with reduced anti-vascular endothelial growth factor (anti-VEGF) treatment requirement and chronicity in patients with acute central serous chorioretinopathy (CSC).Methods: This multicenter retrospective cohort study included treatment-naïve patients with acute CSC from two academic hospitals between January 2022 and December 2024.Patients were classified into a GBE group (Ginexin® 80 mg twice daily, 28 eyes) and a non-GBE group (31 eyes).Best-corrected visual acuity (BCVA), central macular thickness (CMT), subfoveal choroidal thickness (SFCT), and subretinal fluid (SRF) were evaluated at baseline, 6 months, and 12 months.Multivariable logistic regression analysis was performed, adjusting for age, sex, baseline BCVA, and baseline CMT.Results: A total of 59 patients (59 eyes) were included.The GBE group showed a significantly lower rate of anti-VEGF treatment compared to the non-GBE group (35.7% vs. 83.9%,p < 0.001) and fewer injections (3.20 ± 1.87 vs. 5.08 ± 3.07, p = 0.035).GBE use was independently associated with reduced anti-VEGF requirement (adjusted odds ratio [aOR] 0.15, 95% confidence interval [CI] 0.04-0.60;p = 0.008).Chronicity was lower in the GBE group (39.3% vs. 74.2%,p = 0.014), though not significant after adjustment (aOR 0.41, 95% CI 0.12-1.46;p = 0.170).Residual SRF was significantly lower in the GBE group at 6 and 12 months.SFCT reduction from baseline to 12 months was significantly greater in the GBE group (-49.2 ± 23.4 vs. -24.9± 48.4 μm, p = 0.016), remaining significant after adjusting for baseline SFCT (p = 0.019).Conclusions: GBE use was associated with a reduced need for anti-VEGF treatment and greater SFCT reduction in patients with acute CSC, suggesting a possible role in modulating choroidal congestion.Further prospective studies are warranted to confirm these findings.