scholarly journals Diagnostic value of optical coherence tomography angiography for choroidal neovascularization in age-related macular degeneration: A systematic review and meta-analysis

2020 ◽  
Author(s):  
Chang-Xi Chen ◽  
Mei-Ling Liu ◽  
Kai Cao ◽  
Mayinuer Yusufu ◽  
Jin-Da Wang

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.

Folia Medica ◽  
2019 ◽  
Vol 61 (2) ◽  
pp. 317-326
Author(s):  
Vladimir N. Stavrev ◽  
Nelly P. Sivkova ◽  
Desislava N. Koleva-Georgieva

Abstract Age-related macular degeneration is a leading cause of irreversible vision loss in individuals over 55 years of age worldwide. Conventionally, it is divided into two subtypes – dry (non-neovascular) and wet (neovascular) form. Neovascular age-related macular degeneration comprises only 10-15% of all patients but is responsible for more than 80% of blindness related to the disease. It requires early diagnosis and timely treatment. Fluorescein angiography is the current ‘gold standard’ for diagnosing neovascular forms. However, as an invasive procedure, it may be contraindicated in some circumstances and cause serious adverse effects. Optical coherence tomography-angiography is a relatively new, non-invasive and fast imaging modality gaining popularity in the diagnosis of age-related macular degeneration, especially for the neovascular form of the disease. It enables structural and functional information of blood vessels in the retina and choroid, without the need of an intravenous dye. In this study we present and discuss 3 cases of different subtypes of choroidal neovascularization secondary to neovascular age-related macular degeneration. All of them were examined by fluorescein angiography and optical coherence tomography-angiography. The results were qualitatively analyzed.


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