Subthreshold Laser Titration Database in a Population with Central Serous Chorioretinopathy and Dome-Shaped Macula

Objectives: This study aimed to describe the laser titration needed to create a safe and effective subthreshold laser (STL) for use in patients with chronic central serous chorioretinopathy (CSCR) and dome-shaped macula (DSM) and to investigate the possible factors influencing titration. Methods: This was a prospective single-center study that recruited 92 eyes of 87 patients that presented with CSCR (84.8%) and DSM (15.2%) for a 577 nm STL treatment for persistent subretinal fluid. Age, sex, and the spherical equivalent (SE) were collected. Titration was performed by applying various impacts, beginning at 800 mW and increasing in 100 mW steps. The photocoagulation threshold (PT) was assessed as the minimum power at which faint whitening was observed in fundus retinography. Results: The mean age was 53.5 ± 10.3 years and 78.3% of patients were male. The mean SE was 0.3 ± 3.0 D (range -9.5-+11.0). The overall mean power to reach PT was 1102.7 ± 183.0 mW (range 800-1600). In the multivariate analysis, age and SE were associated with PT (p = 0.022 and 0.011, respectively). On the contrary, no association was observed between PT and sex (p = 0.924), macular disease (CSCR vs. DSM, p = 0.416), or central macular thickness (CMT) (p = 0.667). Conclusions: This study highlights the broad power range required for effective subthreshold laser (STL) titration and emphasizes the need for individualized treatment parameters to optimize outcomes. No significant differences in titration power were found regarding macular disease type, CMT, or sex. However, a mild correlation between PT, SE, and age was observed.