Comparison of photodynamic therapy and navigated microsecond laser for chronic central serous chorioretinopathy

Objectives: To compare the visual and anatomical outcomes after photodynamic therapy (PDT) and navigated microsecond laser (nMSL) for chronic central serous chorioretinopathy (CSCR). Methods: This retrospective study included eyes with chronic CSCR who underwent either PDT or nMSL with a minimum of 6 months' follow-up. Eyes with a history of treatment with any other modalities in the past or during 6 months post PDT or microsecond laser follow-up were excluded. Primary outcome measures included change in best-corrected visual acuity (BCVA) and central macular thickness (CMT). Secondary outcome measures included changes in subretinal fluid, hyper-reflective foci, cystic spaces, subfoveal choroidal thickness, and outer retinal structure integrity. Results: Forty-five eyes of 39 subjects (PDT group-23 eyes, nMSL group-22 eyes) with chronic CSCR were analyzed. At 6 months' follow-up, the nMSL group had significantly higher improvement in visual acuity compared to the PDT group (0.12 +/- 0.24 vs -0.02 +/- 0.20 (p = 0.039)). Reduction in central macular thickness was significantly higher in nMSL group compared to the PDT (85.5 +/- 93.26 vs 24.47 +/- 73.18 microns (p = 0.02)). Thirteen (59%) eyes in nMSL group had complete resolution of the SRF at 6 months compared to 5 (21.7%) eyes in PDT group. There was no significant difference in rest of the anatomical features between the groups. Conclusions: nMSL seems to be superior over PDT in improving visual and anatomical outcomes at 6 months and can be considered as a cheap alternative to PDT in treatment of CSCR.