Choroidal Remodeling After Subthreshold Micropulse Laser in Chronic Central Serous Chorioretinopathy: Short-Term Outcomes

Objectives: To evaluate the effects of subthreshold micropulse laser treatment (SMLT) on choroidal architecture in chronic central serous chorioretinopathy (CSC) and their correlations with functional outcomes. Methods: This retrospective study included 48 eyes with chronic CSC that were treated with 577 nm SMLT. The choroidal thickness (CT); Sattler’s layer and choriocapillaris complex thickness (SLCCT); Haller’s layer thickness (HLT); subretinal fluid (SRF); and best-corrected visual acuity (BCVA) were assessed at baseline and at 2 months post treatment. Results: At 2 months, the SLCCT increased from 185.92 ± 80.89 μm to 214.17 ± 83.36 μm (p = 0.023), and the total CT increased from 444.46 ± 80.43 μm to 484.33 ± 93.19 μm (p = 0.002). The SRF height decreased from 140.38 ± 95.89 μm to 57.58 ± 63.54 μm (p < 0.001), with complete resolution in 79.2% of cases. The BCVA improved from 0.41 ± 0.48 to 0.22 ± 0.30 logMAR (p < 0.001). Changes in the SLCCT correlated negatively with BCVA changes (r = −0.48, p = 0.025) and positively with total CT changes (r = 0.687, p < 0.001). Conclusions: SMLT induces significant choroidal remodeling in chronic CSC, particularly affecting the Sattler–Bruch layer complex. The increase in the SLCCT correlates with visual improvement, challenging the conventional understanding of choroidal thinning in CSC treatment.