Effectiveness, Safety and Choroidal Changes of a Fovea-Sparing Technique for the Treatment of Chronic Central Serous Chorioretinopathy with Yellow Subthreshold Laser

The aim of this study was to evaluate the effectiveness and safety of a yellow subthreshold laser (STL) for the treatment of chronic central serous chorioretinopathy delivered in a fovea-sparing pattern and to analyze the post-laser changes in the choroidal structure by Swept-Source Optical Coherence Tomography. This study was a prospective case series of 43 eyes corresponding to 37 patients. Data were recorded at 6, 12 and 24 weeks after the STL treatment. The best-corrected visual acuity improved in 93% of the patients and remained stable in 7%. The subretinal fluid was completely reabsorbed in 27.9%, 32.6% and 69.8% of the patients at 6, 12 and 24 weeks, respectively. There were reductions in the choroidal thickness of 13.1% and 25.3% at 12 and 24 weeks, which corresponded to reductions of 17.5% and 45.9% in the choriocapillaris and Sattler layer and reductions of 12.2% and 21.2% in the Haller layer at 12 and 24 weeks, respectively (p < 0.05). This might account for the effect of the laser on the inner choroidal vasculature, the dysregulation of which is believed to be at the core of central serous chorioretinopathy. No laser-related complications were detected. Overall, the fovea-sparing STL was safe and effective in this series of patients.