This prospective non-inferiority study compared en face OCT-guided vs. fluorescein angiography (FA)-guided navigated focal laser photocoagulation in patients with non-resolving central serous chorioretinopathy (CSCR) with focal leakage, with a primary endpoint of complete subretinal fluid (SRF) resolution at 3 months.
Complete SRF resolution at 3 months was achieved in 84.6% (66/78) of OCT-guided eyes vs. 81.3% (39/48) of FA-guided eyes (p = 0.62); both groups showed significant improvements in BCVA (to LogMAR −0.03) and central retinal thickness (~227 µm), with no adverse events in either group.
Study was non-randomized, raising potential for selection bias between groups. The 3-month follow-up window is relatively short for a condition prone to recurrence. The non-inferiority margin is not explicitly stated in the abstract.
En face OCT alone can guide focal laser for non-resolving CSCR as effectively as FA, potentially sparing patients from dye injection. Clinicians may consider OCT-guided planning as a first-line approach when FA is unavailable or contraindicated.
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