Selective Retina Therapy With Fundus Image-Based Titration in Central Serous Chorioretinopathy: Prospective Outcomes...

We evaluated the clinical outcomes of selective retina therapy (SRT) with fundus image-based titration approach for central serous chorioretinopathy (CSC).

Sixty eyes (60 participants) with chronic CSC prospectively underwent SRT. Treatment (527-nm wavelength, 1.7-µs pulse duration) targeted leakage sites identified via fundus fluorescein angiography. Pulse energy and micropulse number were adjusted based on test-spot fundus images. Changes in best-corrected visual acuity (BCVA), central foveal thickness, subfoveal choroidal thickness, and subretinal fluid (SRF) height were evaluated at baseline and at 1, 2, and 3 months post treatment. Retinal sensitivity was measured by microperimetry at baseline and 3 months. Outcomes were compared between eyes with completely resolved or residual SRF at 3 months.

At 3 months, complete SRF resolution was observed in 80.8% of eyes (42/52). The mean SRF height decreased from 135.6 ± 81.9 µm to 28.0 ± 72.0 µm, and the mean central foveal thickness from 318.9 ± 88.0 µm to 231.9 ± 69.8 µm (both P < 0.001). In parallel, functional parameters also improved, with mean best-corrected visual acuity increasing from 0.17 ± 0.15 logarithm of the minimum angle of resolution to 0.06 ± 0.12 logarithm of the minimum angle of resolution and mean deviation of retinal sensitivity from -0.89 ± 1.65 dB to 0.02 ± 1.29 dB (both P < 0.001). Female sex was significantly associated with persistent SRF in both univariate and multivariable analyses (odds ratio, 30.794; 95% confidence interval, 2.996-774.668; P = 0.011).

SRT with fundus image-based titration yielded favorable functional and anatomical outcomes in CSC. Female sex was associated with persistent SRF, although this finding should be interpreted cautiously.

Fundus image-based titration translates selective retinal pigment epithelium targeting in selective retina therapy into a reproducible clinical approach for central serous chorioretinopathy. This strategy facilitates individualized treatment while remaining compatible with routine clinical practice.