Anatomical Outcomes After Focal Laser Photocoagulation for Central Serous Chorioretinopathy: An Exploratory Retrospective Study

Background/Objectives: Focal laser photocoagulation (FLP) remains an option for nonresolving central serous chorioretinopathy (CSCR) with discrete extrafoveal leakage, but response-associated factors are incompletely characterized. We evaluated anatomical and functional outcomes and imaging correlates after treatment. Methods: This retrospective single-center study included 49 eyes of 47 patients with symptoms lasting at least 6 months. Angiography-guided laser targeted leakage sites more than 250 µm from the foveal center. The primary outcome was complete subretinal fluid (SRF) resolution at Month 3. Associations were assessed using Firth logistic regression, including a post hoc Month-1 landmark analysis. Results: Complete SRF resolution occurred in 26/49 eyes (53.1%) at Month 1, 38/49 (77.6%; 95% CI, 63.4–88.2%) at Month 3, and 35/49 (71.4%) at Month 6; 34/49 (69.4%) achieved sustained Month-3/Month-6 resolution. Month-3 rates were 93.5%, 75.0%, and 30.0% for single focal leakage, multiple focal leakage, and slow ooze, respectively (age- and sex-adjusted global Holm-adjusted p = 0.006) according to fundus fluorescein angiography. Among 23 eyes with residual SRF at Month 1, greater baseline-to-Month-1 central macular thickness reduction was associated with subsequent Month-3 resolution (OR per 100 µm = 7.15; 95% CI, 1.78–121.29; Holm-adjusted p = 0.003). Serous pigment epithelial detachment was associated with lower odds of sustained response (aOR = 0.13; 95% CI, 0.02–0.64; Holm-adjusted p = 0.037). Best-corrected visual acuity improved through Month 6 (estimated change, −0.137 logMAR; Holm-adjusted p = 0.002), and no secondary choroidal neovascularization was detected. Conclusions: Month-3 SRF resolution was frequent in this selected treated cohort. Imaging associations were exploratory and require validation in larger controlled cohorts. The uncontrolled design precludes attribution of resolution solely to FLP, and 6-month follow-up does not establish long-term safety.