Central serous chorioretinopathy imaging biomarkers as potential indicators of response to subthreshold nanosecond laser.

Purpose: The aim of the study was to evaluate optical coherence tomography (OCT) and indocyanine green angiography (ICGA) biomarkers in patients with chronic central serous chorioretinopathy (cCSC) as potential indicators of response to treatment with subthreshold nanosecond laser (NSL).

Methods: In this retrospective study, we examined 36 eyes of 32 cCSC patients after NSL. High response (HR) was defined as complete resolution of subretinal fluid (SRF) 3 months after first NSL treatment, full response (FR) as complete resolution of SRF, 3 months after the last NSL, with all NSL sessions occurring within 1 year from the first NSL. Biomarkers included central macular thickness (CMT), subfoveal choroidal thickness (SFCT), and intervortex venous anastomosis (IVA).

Results: Patients were 54 ± 12 years old on average; 86% were male. OCT at baseline showed a mean CMT of 364 ± 130 µm and SFCT of 292 ± 45 µm; 64% showed IVA in ICGA. HR was seen in 50% and FR in 78%. Higher IVA rates (83% vs. 44%, P = 0.03) predicted poor response after the first NSL. Patients with IVA presence at baseline showed a statistically significant higher likelihood of requiring more than one NSL session compared to those without IVA presence (57% vs. 15%, P = 0.02).

Conclusion: OCT and ICGA biomarkers may play a role as indicators of anatomical responses to NSL. Patients with IVA at baseline showed a poor first response and may need repetitive laser treatments.