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May 4, 2026Open Access

Comparison of the efficacy of subthreshold micropulse laser versus intravitreal anti-VEGF therapy for chronic central serous chorioretinopathy

JLJinyu LiSecond Affiliated Hospital of Zhejiang University TZTiepei ZhuSecond Affiliated Hospital of Zhejiang University YZYanan ZhuQingdao University

Key Points

This study aims to evaluate the effectiveness of subthreshold micropulse laser versus intravitreal anti-VEGF therapy in treating chronic central serous chorioretinopathy.
Review of medical records of 50 cCSCR patients (50 eyes) treated with SML (30 eyes) or IVA (20 eyes).
Assessment of best-corrected visual acuity, central retinal thickness, subretinal fluid, and subfoveal choroidal thickness by optical coherence tomography at multiple time points.
Statistical comparisons of baseline and post-treatment values between both groups.
At 6 months, BCVA improved significantly in both groups (p < 0.05).
SML group showed significantly lower subretinal fluid levels at 6 months (p < 0.05), while IVA reduced subfoveal choroidal thickness more significantly (p < 0.05).
No significant differences were noticed in BCVA and CRT between groups at the mentioned time points (all p > 0.05).

Abstract

ObjectiveTo compare the therapeutic ability between 577-nm subthreshold micropulse laser (SML) and intravitreal anti-VEGF injection (IVA) in the treatment of chronic central serous chorioretinopathy (cCSCR).MethodsThe medical records of 50 cCSCR patients (50 eyes) who underwent SML (30 eyes) or IVA injection (20 eyes) were reviewed in this retrospective cohort study. Changes in best-corrected visual acuity (BCVA), central retinal thickness (CRT), subretinal fluid (SRF), and subfoveal choroidal thickness (SFCT) measured by optical coherence tomography (OCT) at baseline, 1, 3, and 6 months post-treatment were extracted and compared between the two groups.ResultsBaseline demographic and clinical characteristics, including age, sex, leakage pattern on fluorescein angiography (FA), BCVA, CRT, SRF, and SFCT, were comparable between the two groups (all p > 0.05). The mean ± SD of SML sessions and IVA injection were 1.67 ± 0.80 and 1.75 ± 0.97, respectively (p > 0.05). In comparison to the baseline values, BCVA showed statistically significant improvement at 6 months after treatment in both groups (p 0.05). At baseline, 1 month, and the 3 months, there was no statistically significant difference for the SRF and SFCT values between groups (p > 0.05). However, at the 6th month, the SML group demonstrated significantly lower SRF, whereas the IVA group showed significantly lower SFCT (both p < 0.05).ConclusionBoth SML and anti-VEGF has been confirmed effective in improving visual acuity and achieving anatomical recovery in patients with cCSCR. At 6 months, IVA was associated with greater reduction in SFCT, whereas SML achieved superior SRF resolution. These findings support individualized treatment selection based on disease characteristics and underlying pathophysiology.

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