Short-Term Outcomes of Combined Anti-VEGF and Laser Photocoagulation in Chronic Central Serous Chorioretinopathy

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Abstract

Purpose We aimed to assess the short-term anatomical and functional outcomes of combining anti-VEGF therapy with laser photocoagulation in managing chronic central serous chorioretinopathy (cCSC). Methods This retrospective longitudinal study included 15 eyes from 14 patients with cCSC managed at a single tertiary care center between 2020 and 2024. Patients were diagnosed using OCT and FA, with exclusion criteria excluding confounding macular conditions, systemic diseases, prior treatments, and protocol non-compliance. Leakage points were identified based on multimodal imaging to guide photocoagulation, followed by a 0.4 mg intravitreal bevacizumab injection. Follow-ups at 1 and 3 months included BCVA and OCT analysis (CFT, CV, ACT). Statistical significance was set at p < 0.05. Results The cohort (64.3% male; mean age 42.64 ± 12.86 years) showed SRF in 100% of eyes at baseline, with complete resolution in 73.3% at 1 month and 100% by 4 months. FA revealed focal leakage in 86.7% of eyes, most with single leakage points (69.2%). BCVA improved significantly from 0.53 ± 0.39 to 0.31 ± 0.34 (p < 0.0028) over three months. OCT parameters (CFT, CV, ACT) showed significant reductions, indicating improved macular anatomy (p < 0.05). Conclusion Combining anti-VEGF therapy with laser photocoagulation led to meaningful short-term improvements in patients with cCSC, with significant anatomical and functional improvements. This combined strategy may represent a viable therapeutic option, though larger, long-term studies are needed to confirm its efficacy and optimize patient outcomes.

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