PURPOSE: To evaluate the efficacy of navigated subthreshold micropulse laser (NSML) compared to subthreshold micropulse laser (SML) without navigation in the management of chronic central serous chorioretinopathy (CSCR). MATERIALS AND METHODS: This retrospective study included patients diagnosed with chronic CSCR who underwent either NSML or SML without navigation. Patients meeting inclusion criteria presented with serous macular detachment and leakage at the level of the retinal pigment epithelium on fundus fluorescein angiography (FFA). The NSML group underwent treatment using the Navilas® Laser System 577s Prime, operating at a wavelength of 577 nanometers. Micropulse laser application targeted the leakage areas identified on mid-phase FFA images, which were imported into the laser device and aligned with the live image using an eye tracking system. The SML without navigation group underwent treatment using the 577-nanometer yellow laser, delivered through the area centralis laser lens. Laser therapy was guided by focal leaking points and areas of hyperpermeability identified on FFA. RESULTS: A total of 34 patients underwent NSML, while 36 patients received SML without navigation. Both groups were similar in terms of demographic and clinical characteristics. No statistically significant difference was found in visual and anatomical outcomes between the NSML and SML groups at 1 and 3 months post-treatment (P>
0.05). However, favorable outcomes were observed in both groups, with a cumulative probability of successful treatment reaching 73.5% in the NSML group and 63.8% in the SML group. Notably, no adverse events were reported in either group. CONCLUSION: Both NSML and SML without navigation demonstrate efficacy and safety in treating CSCR, with improvements in visual and anatomical outcomes observed during the 3-month follow-up period. NSML emerges as a promising treatment option for facilitating the resolution of subretinal fluid in patients with chronic CSCR.