Efficacy of subliminal laser in chronic central serous chorioretinopathy: A 2.5-Year retrospective study

Purpose To evaluate the efficacy and safety of subliminal laser therapy (SLT) in patients with chronic central serous chorioretinopathy (CSCR). Methods A 2.5-year retrospective analysis (October 2022-March 2025) was conducted on 27 eyes of 25 patients diagnosed with chronic CSCR. Power parameters were individually titrated for each eye. SLT parameters included a 577 nm yellow laser with a 5% duty cycle, pulse duration of 200 ms, and spot size of 160-200 μm. Patients were assessed using multimodal imaging: optical coherence tomography (OCT), OCT angiography, enhanced depth imaging OCT, fluorescein angiography, fundus autofluorescence, and color fundus photography. Results The mean duration of CSCR before SLT was 15.6 ± 11.2 months. 6-8 weeks after first laser application, central retinal thickness decreased from 369 ± 65 to 292 ± 51 μm (p = 0.0015). Visual acuity improved from 0.55 ± 0.16 to 0.67 ± 0.12 (p = 0.11). In 10 eyes (37%), a single SLT session was sufficient, 17 eyes (63%) required two sessions, and 2 eyes (7%) received three sessions. Additionally, 8 eyes (30%) required additional conventional focal laser treatment. Complete subretinal fluid resolution after SLT in the fovea occurred in 63% (17/27 eyes). No complications after SLT were observed. Conclusion SLT appears to be a safe, non-damaging, and effective treatment option for CSCR, particularly in settings where photodynamic therapy (PDT) is unavailable. Further prospective studies are needed to refine treatment protocols and assess long-term outcomes.