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To investigate the association between baseline retinal microstructures including hyperreflective foci (HF), shown by spectral domain optical coherence tomography, and visual outcome and recurrence after laser photocoagulation for central serous chorioretinopathy.We retrospectively reviewed 62 eyes from the medical records of 62 central serous chorioretinopathy patients. At the initial visit, baseline visual acuity, presence of photoreceptor granulation, subretinal fluid thickness, choroidal thickness at the macula, and retinal pigment epithelium status at the leakage site were examined. In addition, the numbers of HF at the macula and the leakage site were counted at the inner, outer, subretinal, and sub–retinal pigment epithelium segmented retinal layers. The statistical correlation was evaluated between the baseline characteristics and the duration of subretinal fluid resolution, duration of visual recovery, and recurrence.Sixty-one of the 62 eyes achieved Snellen best-corrected visual acuity ≥20/22 at the final visit. The duration of subretinal fluid resolution was positively associated with the number of total HF at the macula and the leakage site (P = 0.047 and P = 0.004, respectively). The duration for achieving best-corrected visual acuity ≥20/22 was positively associated with both the baseline logMAR best-corrected visual acuity and the total number of HF at the macula (P < 0.001 and P = 0.02, respectively). Recurrence was positively associated with the presence of irregular retinal pigment epithelium and the number of subretinal HF at the leakage site (P = 0.02 and P = 0.01, respectively).The baseline number of HF observed in spectral domain optical coherence tomography may be able to predict the course of anatomical and functional recovery, and the recurrence of central serous chorioretinopathy.