Optical coherence tomography-guided focal navigated laser photocoagulation in central serous chorioretinopathy: a non-inferiority study.

Abstract

To evaluate the efficacy and safety of en face optical coherence tomography (OCT)-guided navigated focal laser photocoagulation for central serous chorioretinopathy (CSCR). Prospective, non-randomized non-inferiority study. Patients with non-resolving CSCR and focal leakage diagnosed by fluorescein angiography (FA) received navigated focal laser photocoagulation planned in a masked fashion based on either en face OCT or FA. The main outcome measure was complete resolution of subretinal fluid (SRF) within three months. Seventy-eight eyes of 78 patients and 48 eyes of 48 patients were included in the OCT-guided and FA-guided groups, respectively. The mean LogMAR baseline best-corrected visual acuity (BCVA) and central retinal thickness (CRT) in the OCT-guided group were 0.16 ± 0.12 and 379.1 ± 59.2 µm and improved to -0.03 ± 0.06 and 227.1 ± 46.2 µm, respectively (p < 0.001). The mean LogMAR BCVA and CRT in FA-guided group were 0.11 ± 0.08 and 373.8 ± 56.3 µm and improved to -0.03 ± 0.07 and 221.9 ± 43.1 µm, respectively (p < 0.001). Complete resolution of SRF at 3 months was achieved in 66 out of 78 (84.6%) eyes in the OCT-guided group and in 39 out of 48 (81.3%) eyes in the FA-guided group (p = 0.62). No adverse events were registered in either treatment group. Focal navigated laser photocoagulation planned solely based on en face OCT demonstrated non-inferior safety and efficacy compared with conventional FA-guided treatment for non-resolving CSCR with focal leakage.