Visual and Anatomical Improvement in Chronic Central Serous Chorioretinopathy after Juxtafoveal-parafoveal Direct Focal Photocoagulation

Purpose: To evaluate the 6-month functional and anatomical outcomes of conventional 532-nm juxtafoveal-parafoveal direct focal laser photocoagulation for chronic central serous chorioretinopathy (CSC) with localized juxtafoveal-parafoveal leakage.Methods: This retrospective interventional case series included 30 eyes of 30 adults with chronic CSC who underwent direct focal 532nm laser photocoagulation of angiographically defined juxtafoveal-parafoveal leakage.Eyes with leakage within 300 μm of the foveal center or evidence of choroidal neovascularization were excluded.Best-corrected visual acuity (BCVA, logMAR) and central macular thickness (CMT) were assessed at baseline and at 1, 3, and 6 months.Outcomes were compared by Early Treatment Diabetic Retinopathy Study (ETDRS) ring location (inner vs. outer) and leakage pattern (ink-blot vs. smoke-stack).Results: Mean age was 48.5 ± 8.7 years; 76.7% were men; 1.7 ± 1.0 laser sessions were performed per eye.BCVA improved from 0.18 ± 0.22 at baseline to 0.12 ± 0.18 at 1 month (p = 0.022), 0.09 ± 0.15 at 3 months (p < 0.001), and 0.06 ± 0.11 at 6 months (p = 0.001).CMT decreased from 418.1 ± 106.2 μm at baseline to 277.7 ± 66.0, 229.4 ± 75.9, and 222.1 ± 42.4 μm at 1, 3, and 6 months, respectively (all p < 0.001).Outer-ring leakage showed greater CMT reduction than inner-ring leakage at 1, 3, and 6 months (all p ≤ 0.007), while BCVA changes did not differ by ring location.Smoke-stack leakage showed greater BCVA improvement than ink-blot at 1, 3, and 6 months (p = 0.004, <0.001, and 0.037).CSC recurred in 9 eyes (30.0%) at 21.4 ± 14.6 months.Conclusions: Juxtafoveal-parafoveal direct focal 532-nm laser was associated with sustained BCVA improvement and marked CMT reduction through 6 months in chronic CSC with localized juxtafoveal-parafoveal leakage, with a greater anatomical response at outer-ring foci.Prospective comparative studies are warranted.