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Abstract #71298 Published in IGR 18-3
Diagnostic Accuracy of Imaging Devices in Glaucoma: A Meta-Analysis
Fallon M; Valero O; Pazos M; Antón ASurvey of Ophthalmology 2017; 62: 446-461
Imaging devices such as the Heidelberg Retinal Tomograph (HRT3), scanning laser polarimetry (GDx), and optical coherence tomography (OCT), play an important role in glaucoma diagnosis. A systematic search for evidence-based data was performed for prospective studies evaluating the diagnostic accuracy of HRT3, GDx and OCT. The diagnostic odds ratio (DOR) was calculated. To compare the accuracy among instruments and parameters, a meta-analysis considering the hierarchical summary receiver operating characteristic (H-SROC) model was performed. The risk of bias was assessed using quality assessment of diagnostic accuracy studies (QUADAS-2). Studies in the context of screening programs were used for qualitative analysis. 86 manuscripts were included. The DOR values were 29.5 for OCT, 18.6 for GDx, and 13.9 for HRT. The heterogeneity analysis demonstrated statistically a significant influence of degree of damage and ethnicity. Studies analyzing patients with earlier glaucoma showed poorer results. The risk of bias was high for patient selection. Screening studies showed lower sensitivity values and similar specificity values when compared to those included in the meta-analysis. The classification capabilities of GDx, HRT and OCT were high and similar across the 3 instruments. The highest estimated diagnostic odds ratio was obtained with OCT. Diagnostic accuracy could be overestimated in studies including pre-diagnosed groups of subjects.
Department of Pediatrics, Obstetrics, Gynecology and Preventive Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain; Hospital de l'Esperança-Parc de Salut Mar, Ophthalmology Department, Barcelona, Spain. Electronic address: mail@monicafallon.com.
Full articleClassification:
6.9.1.1 Confocal Scanning Laser Ophthalmoscopy (Part of: 6 Clinical examination methods > 6.9 Computerized image analysis > 6.9.1 Laser scanning)
6.9.1.2 Confocal Scanning Laser Polarimetry (Part of: 6 Clinical examination methods > 6.9 Computerized image analysis > 6.9.1 Laser scanning)
6.9.2.2 Posterior (Part of: 6 Clinical examination methods > 6.9 Computerized image analysis > 6.9.2 Optical coherence tomography)
