Diagnostic Value of Optical Coherence Tomography Angiography for Choroidal Neovascularization in Age-Related Macular Degeneration: A Systematic Review and Meta-Analysis

Abstract

Objective: To evaluate the diagnostic value of optical coherence tomography angiography (OCTA) in detecting the choroidal neovascularization (CNV) in agerelated macular degeneration (AMD). Methods: A systematic review and meta-analysis was performed by searching Pubmed, Science Direct, Embase and Web of Science. The pooled sensitivity and specificity with 95% confidence intervals (CIs), area under the summary receiver operator characteristic curve (sROC), and the total accurate classification rate were used to evaluate OCTA’ diagnostic value of CNV in AMD patients. Results: Seven studies involving 517 eyes were included in the analysis. The mean age of subjects in each study ranged from 58.5 years to 81.7 years. Fluorescein angiography was applied as the gold standard in five studies. There were 350 eyes diagnosed with CNV, OCTA detected 301 eyes correctly, while among the 167 eyes without CNV, OCTA identified 150 correctly. The total accurate classification rate was 87.23%. The Spearman's rank correlation coefficient was 0.5, indicating that there was no significant threshold effect in the current study (S=8, p=0.103). The pooled sensitivity and pooled specificity were 0.89 (95%CI: 0.82,0.94) and 0.96 (95%CI: 0.85,1.00) respectively. The area under sROC was up to 0.911. Conclusion: The specificity of OCTA for the detection of CNV in AMD patients is extremely high, however, the sensitivity still needs to be improved. In general, the metaanalysis revealed that OCTA had a high diagnostic value for the detection of CNV in AMD patients.

CGNet‐assisted Automatic Vessel Segmentation for Optical Coherence Tomography Angiography

“…OCTA helps observe the relevant vascular distributions without bringing any side effects to the eyes. By following the microvascular structures at different retina layers, OCTA extracts the microvascular system distributed in the accessory fovea, and thus, could be applied for the early diagnosis of retinal diseases, such as age‐related macular degeneration (AMD) [3], diabetic retinopathy [4], artery and vein occlusions [5], and glaucoma [6]. Furthermore, recent studies also have shown that the retinal microvascular morphological changes revealed by OCTA are related to Alzheimer's disease and mild cognitive impairment (MCI) [7].…”