ObjectiveTo systematically review the diagnostic value of optical coherence tomography angiography (OCTA) for primary open-angle glaucoma (POAG). MethodsThe 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. ResultsA 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. ConclusionOCTA 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.