Diagnostic value of optical coherence tomography angiography in primary open-angle glaucoma: a meta-analysis_Chinese Journal of Evidence-Based Medicine

Authors：

BAI Rong ¹ , ZHAO Yu ¹ , HAO Hongyan ¹ , CHEN Weibai ¹ , LI Sheng ¹ , TIAN Chen ² ,  LI Jun ¹

1. Fifth Department of Ophthalmology, The First People’s Hospital of Lanzhou City, Lanzhou 730000, P. R. China;
2. Department of Health Policy and Management, School of Public Health, Lanzhou University, Lanzhou 730000, P. R. China;

Corresponding author：

LI Jun, Email: 13919176578@163.com

Keywords：

Optical coherence tomography angiography; Primary open-angle glaucoma; Diagnostic test accuracy study; Meta-analysis; Systematic review

DOI：

10.7507/1672-2531.202404126

Video：

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Objective To systematically review the diagnostic value of optical coherence tomography angiography (OCTA) for primary open-angle glaucoma (POAG). Methods The CNKI, WanFang Data, VIP, CBM, PubMed, Embase, Web of Science, and Cochrane Library databases were electronically searched to collect diagnostic test on OCTA for POAG from inception to February 2024. Two reviewers independently screened literature, extracted data and assessed the risk of bias of the included studies. Meta-analysis was then performed by using Stata 15.0 software. Results A total of 12 diagnostic tests involving 993 subjects were included. Meta-analysis results showed that the sensitivity/specificity of OCTA for diagnosing peripapillary vessel density, retinal vessel density, and optic nerve fiber changes in patients with POAG were 0.77/0.92, 0.56/0.92, and 0.85/0.91, respectively, and the AUC of the sROC curve was 0.94, 0.92 and 0.95, respectively. Conclusion OCTA has high diagnostic accuracy for POAG. Due to the limited quality and quantity of the included studies, more high quality studies are needed to verify the above conclusion.

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2.	张鑫, 杨蓉, 曾继红. 原发性青光眼患者自我管理行为现状及影响因素研究. 华西医学, 2022, 37(4): 568-574.
3.	王云, 樊宁, 刘旭阳. 原发性开角型青光眼相关基因及发病机制研究进展. 中华眼视光学与视觉科学杂志, 2019, 21(10): 796-800.
4.	田晨, 杨秋玉, 赖鸿皓, 等. 诊断性试验准确性比较研究. 中国循证医学杂志, 2022, 22(5): 590-594.
5.	de Carlo TE, Romano A, Waheed NK, et al. A review of optical coherence tomography angiography (OCTA). Int J Retina Vitreous, 2015, 1: 5.
6.	中华医学会眼科学分会青光眼学组. 我国原发性青光眼诊断和治疗专家共识(2014年). 中华眼科杂志, 2014, 50(5): 382-383.
7.	Whiting PF, Rutjes AW, Westwood ME, et al. QUADAS-2: a revised tool for the quality assessment of diagnostic accuracy studies. Ann Intern Med, 2011, 155(8): 529-536.
8.	曲艳吉, 杨智荣, 孙凤, 等. 偏倚风险评估系列: (六)诊断试验. 中华流行病学杂志, 2018, 39(4): 524-531.
9.	张恒丽, 李树宁, 闫晓伟, 等. 分离格栅视觉诱发电位和光学相干断层扫描血管成像术在原发性开角型青光眼早期诊断中的相关性. 眼科学报, 2020, 35(6): 405-412.
10.	Rao HL, Pradhan ZS, Weinreb RN, et al. Regional comparisons of optical coherence tomography angiography vessel density in primary open-angle glaucoma. Am J Ophthalmol, 2016, 171: 75-83.
11.	Geyman LS, Garg RA, Suwan Y, et al. Peripapillary perfused capillary density in primary open - angle glaucoma across disease stage : an optical coherence tomography angiography study. Br J Ophthalmol, 2017, 101(9): 1261-1268.
12.	Rao HL, Pradhan ZS, Weinreb RN, et al. Optical coherence tomography angiography vessel density measurements in eyes with primary open-angle glaucoma and disc hemorrhage. J Glaucoma, 2017, 26(10): 888-895.
13.	Chen A, Liu L, Wang J, et al. Measuring glaucomatous focal perfusion loss in the peripapillary retina using OCT angiography. Ophthalmology, 2020, 127(4): 484-491.
14.	Chang R, Chu Z, Burkemper B, et al. Effect of scan size on glaucoma diagnostic performance using OCT angiography en face images of the radial peripapillary capillaries. J Glaucoma, 2019, 28(5): 465-472.
15.	Rao HL, Kadambi SV, Weinreb RN, et al. Diagnostic ability of peripapillary vessel density measurements of optical coherence tomography angiography in primary open-angle and angle-closure glaucoma. Br J Ophthalmol, 2017, 101(8): 1066-1070.
16.	Tabl AA, Tabl MA. Correlation between OCT-angiography and photopic negative response in patients with primary open angle glaucoma. Int Ophthalmol, 2023, 43(6): 1889-1901.
17.	Wan KH, Lam AKN, Leung CK. Optical coherence tomography angiography compared with optical coherence tomography macular measurements for detection of glaucoma. JAMA Ophthalmol, 2018, 136(8): 866-874.
18.	Akil H, Huang AS, Francis BA, et al. Retinal vessel density from optical coherence tomography angiography to differentiate early glaucoma, pre-perimetric glaucoma and normal eyes. PLoS One, 2017, 12(2): e0170476.
19.	Akil H, Chopra V, Al-Sheikh M, et al. Swept-source OCT angiography imaging of the macular capillary network in glaucoma. Br J Ophthalmol, 2018, 102: 515-519.
20.	吴艳, 杨璐. 原发性开角型青光眼诊断的研究现状. 国际眼科杂志, 2021, 21(9): 1552-1556.
21.	Bonomi L, Marchini G, Marraffa M, et al. Vascular risk factors for primary open angle glaucoma: the Egna-neumarkt study. Ophthalmology, 2000, 107(7): 1287-1293.
22.	吴玲玲. 如何运用OCTA助力青光眼诊治. 眼科, 2023, 32(1): 1-5.
23.	杨香香, 何媛, 张坚. OCTA技术在原发性青光眼中的应用研究进展. 国际眼科杂志, 2021, 21(1): 57-61.
24.	田晨, 杨秋玉, 赖鸿皓, 等. 诊断试验准确性比较研究的统计分析. 中国循证医学杂志, 2022, 22(12): 1474-1482.
25.	吴宇桥. OCTA对原发性青光眼诊断价值的Meta分析. 福州: 福建医科大学, 2018.
26.	Moradi Y, Moradkhani A, Pourazizi M, et al. Diagnostic accuracy of imaging devices in glaucoma: an updated meta-analysis. Med J Islam Repub Iran, 2023 Apr 15: 37: 38.

1. Weinreb RN, Khaw PT. Primary open-angle glaucoma. Lancet, 2004, 363(9422): 1711-1720.
2. 张鑫, 杨蓉, 曾继红. 原发性青光眼患者自我管理行为现状及影响因素研究. 华西医学, 2022, 37(4): 568-574.
3. 王云, 樊宁, 刘旭阳. 原发性开角型青光眼相关基因及发病机制研究进展. 中华眼视光学与视觉科学杂志, 2019, 21(10): 796-800.
4. 田晨, 杨秋玉, 赖鸿皓, 等. 诊断性试验准确性比较研究. 中国循证医学杂志, 2022, 22(5): 590-594.
5. de Carlo TE, Romano A, Waheed NK, et al. A review of optical coherence tomography angiography (OCTA). Int J Retina Vitreous, 2015, 1: 5.
6. 中华医学会眼科学分会青光眼学组. 我国原发性青光眼诊断和治疗专家共识(2014年). 中华眼科杂志, 2014, 50(5): 382-383.
7. Whiting PF, Rutjes AW, Westwood ME, et al. QUADAS-2: a revised tool for the quality assessment of diagnostic accuracy studies. Ann Intern Med, 2011, 155(8): 529-536.
8. 曲艳吉, 杨智荣, 孙凤, 等. 偏倚风险评估系列: (六)诊断试验. 中华流行病学杂志, 2018, 39(4): 524-531.
9. 张恒丽, 李树宁, 闫晓伟, 等. 分离格栅视觉诱发电位和光学相干断层扫描血管成像术在原发性开角型青光眼早期诊断中的相关性. 眼科学报, 2020, 35(6): 405-412.
10. Rao HL, Pradhan ZS, Weinreb RN, et al. Regional comparisons of optical coherence tomography angiography vessel density in primary open-angle glaucoma. Am J Ophthalmol, 2016, 171: 75-83.
11. Geyman LS, Garg RA, Suwan Y, et al. Peripapillary perfused capillary density in primary open - angle glaucoma across disease stage : an optical coherence tomography angiography study. Br J Ophthalmol, 2017, 101(9): 1261-1268.
12. Rao HL, Pradhan ZS, Weinreb RN, et al. Optical coherence tomography angiography vessel density measurements in eyes with primary open-angle glaucoma and disc hemorrhage. J Glaucoma, 2017, 26(10): 888-895.
13. Chen A, Liu L, Wang J, et al. Measuring glaucomatous focal perfusion loss in the peripapillary retina using OCT angiography. Ophthalmology, 2020, 127(4): 484-491.
14. Chang R, Chu Z, Burkemper B, et al. Effect of scan size on glaucoma diagnostic performance using OCT angiography en face images of the radial peripapillary capillaries. J Glaucoma, 2019, 28(5): 465-472.
15. Rao HL, Kadambi SV, Weinreb RN, et al. Diagnostic ability of peripapillary vessel density measurements of optical coherence tomography angiography in primary open-angle and angle-closure glaucoma. Br J Ophthalmol, 2017, 101(8): 1066-1070.
16. Tabl AA, Tabl MA. Correlation between OCT-angiography and photopic negative response in patients with primary open angle glaucoma. Int Ophthalmol, 2023, 43(6): 1889-1901.
17. Wan KH, Lam AKN, Leung CK. Optical coherence tomography angiography compared with optical coherence tomography macular measurements for detection of glaucoma. JAMA Ophthalmol, 2018, 136(8): 866-874.
18. Akil H, Huang AS, Francis BA, et al. Retinal vessel density from optical coherence tomography angiography to differentiate early glaucoma, pre-perimetric glaucoma and normal eyes. PLoS One, 2017, 12(2): e0170476.
19. Akil H, Chopra V, Al-Sheikh M, et al. Swept-source OCT angiography imaging of the macular capillary network in glaucoma. Br J Ophthalmol, 2018, 102: 515-519.
20. 吴艳, 杨璐. 原发性开角型青光眼诊断的研究现状. 国际眼科杂志, 2021, 21(9): 1552-1556.
21. Bonomi L, Marchini G, Marraffa M, et al. Vascular risk factors for primary open angle glaucoma: the Egna-neumarkt study. Ophthalmology, 2000, 107(7): 1287-1293.
22. 吴玲玲. 如何运用OCTA助力青光眼诊治. 眼科, 2023, 32(1): 1-5.
23. 杨香香, 何媛, 张坚. OCTA技术在原发性青光眼中的应用研究进展. 国际眼科杂志, 2021, 21(1): 57-61.
24. 田晨, 杨秋玉, 赖鸿皓, 等. 诊断试验准确性比较研究的统计分析. 中国循证医学杂志, 2022, 22(12): 1474-1482.
25. 吴宇桥. OCTA对原发性青光眼诊断价值的Meta分析. 福州: 福建医科大学, 2018.
26. Moradi Y, Moradkhani A, Pourazizi M, et al. Diagnostic accuracy of imaging devices in glaucoma: an updated meta-analysis. Med J Islam Repub Iran, 2023 Apr 15: 37: 38.

Chinese Journal of Evidence-Based Medicine

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