Effect of Subthreshold Micropulse Diode Laser for Treatment of Central Serous Chorioretinopathy

Abstract

Background: Central serous chorioretinopathy (CSCR) is a chorioretinal disorder characterized by serous retinal detachment that may lead to persistent visual impairment, particularly in chronic cases. The subthreshold micropulse diode laser (SMDL) has emerged as a tissue-sparing therapeutic option for targeting retinal pigment epithelium dysfunction.

Objective: To evaluate the efficacy and safety of subthreshold micropulse diode laser therapy in the management of CSCR.

Methods: This prospective interventional study included 22 eyes diagnosed with CSCR. All eyes were treated with 810-nm SMDL applied to the affected area. Patients were followed monthly for a period of 6 months. Outcome measures included best-corrected visual acuity (BCVA) and swept-source optical coherence tomography (SS-OCT) parameters, namely subretinal fluid (SRF), central retinal thickness (CRT), and subfoveal choroidal thickness (SCT).

Results: The mean age of the studied patients was 42 ± 11 years, with a male predominance (82.4%). At the 6-month follow-up, complete resolution of SRF was achieved in 11 eyes (50%), while partial reduction was observed in 4 eyes (18.2%), yielding an overall anatomical success rate of 68.2%. Recurrence occurred in 5 eyes (22.7%), and treatment failure was noted in 2 eyes (9.1%). Significant improvements were observed between baseline and final follow-up in BCVA, SRF height, CRT, and SCT (p < 0.05).

Conclusions: Subthreshold micropulse diode laser therapy is a safe and effective treatment modality for CSCR, leading to significant functional and anatomical improvements with a favorable recurrence profile. SMDL promotes accelerated absorption of subretinal fluid, improves visual acuity, and significantly reduces choroidal thickness without inducing detectable retinal damage. Repeated micropulse sessions can be performed safely, supporting SMDL as a viable therapeutic option in the management of CSCR.