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Abstract #81590 Published in IGR 20-4

Diagnostic performance of optical coherence tomography angiography in glaucoma: a systematic review and meta-analysis

Miguel AIM; Silva AB; Azevedo LF
British Journal of Ophthalmology 2019; 103: 1677-1684


BACKGROUND: Compared with current imaging methods, the diagnostic performance and the advantages and limitations of optical coherence tomography angiography (OCTA) remain unclear. We performed a systematic review and meta-analysis of studies investigating vessel density (VD) in patients with glaucoma using OCTA. METHODS: We conducted a literature search on PubMed, Scopus, Web of Science, ISI Conference Proceedings and Google Scholar, along with a manual search, from January 2006 to March 2018. We included prospective studies that used OCTA to compare the VD in glaucomatous eyes with healthy control eyes. RESULTS: Of 3045 screened articles, 24 were included in a broad characterisation and 18 in the meta-analysis. We observed a statistically significant reduction in the mean peripapillary VD (MPVD) in glaucoma (MPVD: 57.53%, 95% CI 52.60 to 62.46, p< 0.001) compared with controls (MPVD: 65.47%, 95% CI 59.82 to 71.11; standardised mean difference [SMD], -1.41, 95% CI -1.62 to -1.20, p< 0.001) for 888 glaucomatous and 475 healthy eyes, and also in the mean-whole optic nerve image VD (SMD, -9.63, 95% CI -10.22 to -9.03, p<0.001), mean inside-disc VD (SMD, - 9.51, 95% CI -12.66 to -6.36, p<0.05) and mean parafoveal VD (SMD, -3.92, 95% CI -4.73 to -3.12, p<0.001). Subgroup analyses revealed a significant difference in the MPVD across glaucoma subtypes and OCTA devices. CONCLUSION: This suggests the diagnostic utility of OCTA in detecting glaucomatous eyes; however, further longitudinal prospective studies are welcomed to characterise vascular changes in glaucoma.

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Classification:

6.9.2.2 Posterior (Part of: 6 Clinical examination methods > 6.9 Computerized image analysis > 6.9.2 Optical coherence tomography)
6.11 Bloodflow measurements (Part of: 6 Clinical examination methods)



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