Terapia Fotodinâmica Primária Guiada por Angiografia Fluoresceínica Versus Angiografia com Verde de Indocianina para o Tratamento da Coriorretinopatia Serosa Central: Uma Revisão Sistemática com Meta-Análise
DOI:
https://doi.org/10.48560/rspo.42414Palavras-chave:
Angiografia, Coróide, Coriorretinopatia Serosa Central, Angiografia fluoresceínica, Angiografia com verde de indocianina, Terapia fotodinâmicaResumo
INTRODUÇÃO: O nosso objetivo foi rever de forma sistemática a evidencia que compara a utilização da angiografia fluoresceínica (FA) versus a angiografia com verde de indocianina (ICGA) como guia para a terapia fotodinâmica (PDT) primária na corioretinopatia serosa central (CSC).
MÉTODOS: Foram pesquisadas as bases de dados PubMed, Web of Science, Scopus e Cochrane Library para todos os estudos relevantes publicados desde a sua criação até 26 de maio de 2024. Foram incluídos estudos que compararam os resultados clínicos da PDT primária guiada por FA versus ICGA em olhos com CSC crónica. Os principais desfechos analisados foram a acuidade visual corrigida (BCVA), a espessura macular central (CMT), a espessura coroideia subfoveal (SFCT) e a resolução do fluido sub-retiniano (SRF). Foi realizada uma meta-análise com um modelo de efeitos aleatórios.
RESULTADOS: De 451 resumos identificados, 3 estudos foram considerados elegíveis, envolvendo 179 olhos de 170 doentes com CSC tratados com PDT, dos quais 82 guiados por FA e 97 por ICGA. Em todos os estudos, observou-se melhoria da BCVA e redução da CMT e da SCFT com a PDT, independentemente do tipo de angiografia utilizada como referência, quando comparadas com os valores basais. A meta-análise não revelou diferenças significativas entre a PDT guiada por FA e por ICGA na alteração da BCVA (DM -0,01 [-0,07, 0,05] logMAR, p = 0,71), CMT (DM -5,76 [-43,67, 32,15] μm, p = 0,77) e SFCT (DM 16,00 [-8,81, 40,82] μm, p = 0,21). A resolução completa do SRF na última visita de seguimento foi observada em 70% a 100% dos doentes.
CONCLUSÃO: A evidência disponível até ao momento sugere que a PDT com meia-dose guiada por FA ou por ICGA é igualmente eficaz e segura no tratamento da CSC crónica.
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