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

Abstract

BackgroundCompared 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.MethodsWe 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.ResultsOf 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.ConclusionThis suggests the diagnostic utility of OCTA in detecting glaucomatous eyes; however, further longitudinal prospective studies are welcomed to characterise vascular changes in glaucoma.

OCT-angiography detects longitudinal microvascular changes in glaucoma: a systematic review

“…A comprehensive search was performed using four electronic databases from inception to September 20 th 2019 -MEDLINE, Scopus, ISI Web of Science, and Google Furthermore, through grey literature, unpublished data, and a hand search of references of the included studies and reviews, additional studies were identified. The review protocol was registered 26 on PROSPERO (record number CRD42020153576).…”

“…16 Third, OCTA may provide information on the vascular pathophysiology of glaucoma. 17 Previous studies, including a meta-analysis 18 , have shown that OCTA can be useful for glaucoma diagnosis. 19 More recently, studies have evaluated the ability of OCTA to detect and measure glaucoma progression.…”

Circumpapillary optical coherence tomography angiography differences in perimetrically affected and unaffected hemispheres in primary open-angle glaucoma and the preperimetric fellow eye

“…found a significant reduction in mean circumpapillary vessel density reported in glaucomatous eyes for many OCTa devices. [ 20 ] Moghimi et al . were able to show a correlation between vessel density and visual field MD, even in advanced glaucoma.…”

Optical Coherence Tomography in Patients with Alzheimer’s Disease: What Can It Tell Us?

“…107,108 Other chronic eye diseases such as glaucoma or age-related macular degeneration may also impact the results of OCT/OCTA findings. [109][110][111] In addition, certain OCT/OCTA findings such as FAZ size can vary by age, race, or sex, 112,113 and can vary substantially between individuals thus limiting its utility. Moreover, if these factors are not controlled for in the analysis, then the relationship between FAZ and AD or MCI can be confounded.…”