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Purpose: To evaluate the efficacy of navigated focal laser photocoagulation in patients with chronic central serous chorioretinopathy (CSCR) and active leakage on fluorescein angiography (FA)., Methods: Thirty-two eyes of 32 patients (age 48 ± 11, m/f = 24/8) with persistent or recurrent CSCR (> 3 months) who received navigated laser photocoagulation (Navilas®) of leaking point(s) between June 2013 and 2016 were included in this retrospective case series. Outcome parameters after 4 weeks and 3 months were the number of patients presenting with complete resolution of subretinal fluid, the volume of subretinal fluid measured on SD-OCT (Spectralis Heidelberg Engineering©), and best corrected visual acuity (BCVA/ (Snellen equivalent)., Results: Complete resolution of subretinal fluid was achieved in 17 eyes (50%) after 4 weeks and in 24 eyes (75%) after 3 months with an average number of 1.3 laser procedures (range 1-3). Five eyes displayed a nearly complete resolution with a reduction of over 80% of the subretinal fluid compared to baseline. Three eyes showed no reduction in subretinal fluid. BCVA improved from median 0.58 (range 0.16-1.25) to 0.66 (0.16-1.0) (p = 0.001). The seven patients who had been treated within the central 1 mm of the ETDRS-OCT Grid but outside the avascular foveal zone showed an improvement of BCVA from median 0.6 (range 0.2-1.0) to 0.8 (0.2-1.0). No patient experienced a treatment-induced visual loss., Conclusions: Laser treatment with Navilas® using eye tracking and FA-based planning is a safe and effective alternative therapy in patients with chronic CSCR.

Background: Although it is known that antioxidants including lutein can affect macular pigment optical density (MPOD) and visual function, we still have much to learn about their effect. Our aim was to assess the 1-year changes in MPOD and visual function in response to supplementation containing lutein., Methods: We prospectively measured the MPOD level of those who received a supplement containing 6 mg of lutein daily for 1 year. MPOD level was measured every 3 months by using autofluorescence spectrometry with the two-wavelength method. Other examinations, including contrast sensitivity and retinal sensitivity were also measured every 3 or 6 months. Stepwise regression analysis was performed to determine the factors that correlated with the changes observed in those examinations., Results: Forty-three eyes of 43 Japanese subjects, including five normal eyes, five fellow eyes with central serous chorioretinopathy (CSC), and 33 fellow eyes with age-related macular degeneration (AMD) were enrolled. The higher baseline MPOD level was correlated with the eye with a clear intraocular lens (IOL). Although no time-dependent changes in the MPOD level were obtained in any area, subjects without cardiovascular diseases showed higher increase in the MPOD level. We observed significant increases in the contrast sensitivity at 1 year (p = 0.0124) and in the retinal sensitivity at 6 months (p < 0.0001) and 1 year (p < 0.0001). Stepwise regression analysis showed that nonsmokers had increased contrast sensitivity (p = 0.0173), and the fellow eye of those with CSC had less of an increase in retinal sensitivity (p = 0.0491)., Conclusions: Daily supplementation with 6 mg of lutein did not affect the MPOD level for 1 year, suggesting that 6 mg of lutein may be insufficient to increase the MPOD level. However, supplementation seems to improve visual functions such as contrast sensitivity and retinal sensitivity.