Transfoveal Micropulse Laser Treatment of Central Serous Chorioretinopathy within Six Months of Disease Onset

Background: It has been recommended that any invasive treatment performed in patients with central serous chorioretinopathy (CSCR) not be initiated earlier than four months after disease onset due to the potential for spontaneous remission of symptoms. The goal of this study was to examine the outcome of transfoveal subthreshold micropulse laser treatment (SMPLT) of CSCR performed at six months or less after disease onset. Materials and methods: The study included 32 cases of CSCR lasting between three weeks and six months (mean: 3.4 +/- 2.3 months). All patients had transfoveal SMPLT applied and were followed for at least three months after each session of SMPLT. Two sessions of SMPLT in total were planned in case of an insufficient response to the first instance of treatment. Evaluation parameters included any change in best-corrected visual acuity (BCVA) and retinal morphology. Results: Total resolution of subretinal fluid (SRF) was noted in 26 cases (81.25%). Final BCVA improved significantly from 0.37 +/- 0.22 logMAR to 0.22 +/- 0.20 logMAR after treatment. Overall, early SMPLT correlated with better final BCVA (p = 0.0005, Spearman rank correlation). For eyes achieving a total resolution of SRF, BCVA improved from 0.33 +/- 0.21 logMAR to 0.17 +/- 0.14 logMAR (p = 0.004, Spearman rank correlation). The analysis of SMPLT nonresponders revealed a tendency for poorer baseline visual acuity. Conclusions: Patients with CSCR lasting six months or less treated with transfoveal SMPLT achieve better functional results with early application of this procedure. As baseline BCVA predicts final visual acuity, earlier treatment, permitted by the safety of SMPLT, may improve final visual outcomes.