Subthreshold Continuous Wave Autofluorescence‑controlled Laser Treatment of Chronic Central Serous Chorioretinopathy

Purpose: To investigate the therapeutic effect of clinically invisible subthreshold continuous wave autofluorescence‑controlled laser treatment on visual acuity and macular status of patients with chronic central serous chorioretinopathy (CSCR). Methods: In this prospective case series, patients with clinical and fluorescein angiographic (FA) findings of CSCR and chronic visual loss (>6 months) were included. Complete ocular examination, FA, and optical coherence tomography (OCT) tests were performed. Each eye was subjected to a direct laser treatment of leakage points by 532 nm continuous wave low energy laser pulses, which were kept invisible by reducing the power to 70% of the threshold test spot. Considering the lack of visible effect on the retinal pigment epithelium (RPE), the laser effect was monitored by pre‑ and post ‑treatment infrared and autofluorescence images. Results: A total of 20 patients were included in this study, of whom 12 patients (9 male and 3 female patients) with an average age of 38 years had complete follow‑up (Average: 3.5 months). The mean preoperative visual acuity was 20/80, which improved to 20/40 at the final visit. The mean preoperative central macular thickness (CMT) was 330 μm and the average final CMT in the last OCT test was 188 μm (P = 0.001). Conclusion: Subthreshold continuous wave autofluorescence‑controlled laser treatment may be a good treatment for chronic CSCR to avoid the risks of retinal damage by clinically suprathreshold laser therapy.