Which of the following is a treatment option for persistent CSR?

• A. Increase steroid use
• B. Focal laser to PED source
• C. Immediate vitrectomy
• D. Laser to the foveal center in all cases

Answer: (B)

Persistent CSR is about chronic fluid under the retina from leakage that the RPE and choroid aren’t handling well. When a discrete leakage point can be identified, focusing laser energy directly at that leak can seal the defect, helping the RPE pump start working again and allowing the subretinal fluid to be reabsorbed. This approach is used only if the leak is well defined and not under the fovea, to avoid harming central vision.

Increasing steroids would make CSR worse, immediate vitrectomy isn’t a standard treatment for CSR, and laser applied to the foveal center in all cases risks significant central vision loss, so it isn’t the appropriate universal strategy.