Sensitivity and specificity of optical coherence tomography angiography for diagnosis and classification of diabetic retinopathy; a systematic review and meta-analysis

Abstract

Background Optical coherence tomography angiography (OCTA) is a noninvasive imaging method that can be used for the staging of diabetic retinopathy. In addition, alterations in OCTA parameters can precede the clinical fundus changes. In this review, we aimed to assess the accuracy of OCTA in diagnosis and staging of diabetic retinopathy. Methods Two independent reviewers participated in the literature search using electronic databases (PubMed, Embase, Cochrane Library Central Register of Controlled Trials, ISI, and Scopus) from inception till December 2020. The heterogeneity of data was assessed by Q statistics, Chi-square test and I2 index. Results Forty-four articles published from 2015 to the end of 2020 were included in this meta-analysis. Of these, 27 were case-control studies, 9 were case series, and 8 were cohort studies. In total, 4284 eyes of 3553 patients were assessed in this study. OCTA could differentiate diabetic retinopathy from diabetes without diabetic retinopathy with a sensitivity of 88% (95% CI: 85% to 92%) and specificity of 88% (95% CI: 85% to 91%). In addition, it could differentiate proliferative diabetic retinopathy from non-proliferative diabetic retinopathy with a sensitivity of 91% (95% CI: 86% to 95%) and specificity of 91% (95% CI:86% to 96%). The sensitivity of OCTA for diagnosing diabetic retinopathy was increased by the size of scan (3 × 3 mm: 85%; 6 × 6 mm: 91%, 12 × 12 mm: 96%). Conclusion OCTA, as a non-invasive method, has acceptable sensitivity and specificity for diagnosis and classification of diabetic retinopathy. A larger scan size is associated with more sensitivity for discriminating diabetic retinopathy.

Optical Coherence Tomography Angiography Changes in Patients Diagnosed With Acute Coronary Syndrome: A Systematic Review and Meta-Analysis

“…Thus, it gives a detailed evaluation of the microvascular network and segmentation of the FAZ, as well as the superficial, deep, and choroidal plexus [33]. During the past few years, a number of systematic reviews and meta-analyses have been published that elucidate the role of OCTA in ophthalmic conditions, their diagnosis, and classification such as diabetic retinopathy (DR), glaucoma, retinal vasculitis, and myopic choroidal neovascularization [34][35][36][37]. A number of recent systematic reviews and meta-analyses have also introduced the invaluable role of OCTA changes in retinal microvascular network as potential novel biomarkers in diseases such as hypertension, multiple sclerosis, Alzheimer's disease, and Parkinson's disease [38][39][40][41].…”

Retinal and choroidal microvascular characterization and density changes in different stages of diabetic retinopathy eyes

“…OCTA is a new retinal blood flow detection method in recent years, which can non-invasively identify different vascular plexuses of retina and choroidal blood perfusion. OCTA was recently used for the staging of DR, which has acceptable sensitivity and specificity for diagnosis and classification of DR ( 4 ).…”