Dark‑Field Scanning Laser Ophthalmoscopy for Prediction of Central Serous Chorioretinopathy Responsiveness to Laser Therapy

Purpose: To study the potential of dark‑field scanning laser ophthalmoscopy (DF‑SLO) for the prediction of central serous chorioretinopathy (CSC) responsiveness to laser therapy. Methods: Fifty‑two eyes of 52 patients (44 males and 8 females, mean age of 45.4 ± 8.8 years) newly diagnosed with CSC were included in this prospective cohort study. At baseline, all patients received multimodal imaging including DF‑SLO and then were observed until resolution of subretinal fluid or, in nonresolving cases, treated with laser therapy. At the end of the follow‑up, each case was categorized as either self‑resolving, resolving after laser treatment, or nonresolving after laser treatment. Presence of granular retinal pigment epithelium (RPE) changes and lucency of RPE/choroid complex at the leak on DF‑SLO images were used by two masked graders to identify cases nonresolving after laser treatment. Results: Using DF‑SLO images, the masked grader correctly classified 45 of 52 (86.5%) CSC cases. Kappa value for the classification by two graders was 0.95 (95% confidential interval [CI] 0.85–1.0). The area under the receiver operating curve, sensitivity, and specificity of DF‑SLO in identifying nonresolving after laser treatment cases were 0.92 (95% CI: 0.79–0.98), 86.7% (95% CI: 59.5%–98.3%), and 96.6% (95% CI: 82.2%–99.2%), respectively. Conclusion: DF‑SLO may be a useful technique in prognostication of response to laser treatment in newly diagnosed CSC.