Micropulse Laser versus Eplerenone for Chronic Central Serous Chorioretinopathy: A 12-Month Comparison

Abstract Introduction To compare the long-term efficacy of navigated subthreshold micropulse laser (NSML) and continuous oral eplerenone (EPL) in chronic central serous chorioretinopathy (cCSC). Methods This retrospective observational study included 44 eyes with cCSC (EPL: n = 26; NSML: n = 18). Best-corrected visual acuity (BCVA), central macular thickness (CMT), subretinal fluid (SRF) height, and subfoveal choroidal thickness (SFCT) were evaluated over 12 months. Results Both groups showed significant improvements in BCVA and CMT (p 0.05). Conclusions Both NSML and EPL improved retinal morphology and visual function in patients with cCSC. NSML achieved faster SRF resolution, while EPL resulted in more significant choroidal thickness reduction. These findings suggest distinct mechanisms of action: NSML primarily affects the retinal pigment epithelium, while EPL modulates choroidal vasculature. Treatment choice may depend on individual patient characteristics and treatment goals.