Direct and indirect laser photocoagulation of central serous choroidopathy

A 3 1/2-year prospective randomized clinical trial showed a definite superiority of direct argon laser photocoagulation to the fluorescein leaking site compared to indirect treatment away from the leak in patients with central serous choroidopathy. One patient in each treatment group developed a subretinal neovascular membrane after photocoagulation to the fluorescein leak. Moderate prolongation of the neurosensory detachment did not adversely influence the final visual acuity in the indirect treatment group. Although direct laser photocoagulation reduces the duration of central serous choroidopathy, there is a risk of producing subretinal neovascularization. The principles of risk vs benefit should be explained to all patients and treatment should be advised only for compelling reasons.