Long-term outcomes of titration-guided focal selective retina therapy for chronic central serous chorioretinopathy: retrospective real-world data analysis

OBJECTIVES: This retrospective study aimed to evaluate the effect of titration-guided focal selective retina therapy (SRT) for chronic central serous chorioretinopathy (cCSCR) and determine the need and effectiveness of re-treatment. METHODS: SRT was performed in 60 eyes of 57 patients with cCSCR, targeting focal leakage points (FLP) using a Nd:YLF-Laser at 527 nm (R:GEN®, Lutronic, South Korea) titration-guided at 80% threshold, with 140 ms irradiation time, 100 Hz frequency, 1.7 µs pulse duration, 200 µm spot size. Best documented visual acuity (BDVA), peak height of subretinal fluid (SRF), height of SRF at the fovea, central retinal thickness (cRT) and total macular retinal volume (tRV) were measured. RESULTS: A significant improvement in BDVA was observed up to 1 year compared to baseline (p < 0.02). A limited analysis due to the small sample size showed no significant difference between the BDVA at baseline and 2-year (n = 15) and 3-year (n = 10) follow-ups. A significant decrease in the height of the SRF at the highest point and fovea and total retinal volume up to the 3-year follow-up was observed compared to the baseline (p < 0.03). Thirty (50%) eyes of 30 patients required re-treatment, on average 9.2 ± 9.6 months after the initial SRT. This study found no predictors for the need of re-treatment. CONCLUSIONS: The study concludes that SRT is safe and shows anatomical and functional benefits for treating cCSCR. We recommend performing regular check-ups every three months and following a zero-fluid tolerance policy for re-treatment. TRIAL REGISTRATION: German Clinical Trials Register ID: DRKS00031038, registration date: 2023-01-16