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Eye (London, England)
Dec, 2014;28 (12): 1399-406.

Optical coherence tomography for the diagnosis of neovascular age-related macular degeneration: a systematic review.

M M Castillo, G Mowatt, N Lois, A Elders, C Fraser, W Amoaku, J M Burr, A J Lotery, C R Ramsay, A Azuara-Blanco
Author Information
  1. M M Castillo: Health Services Research Unit, University of Aberdeen, Scotland, UK.
  2. G Mowatt: Health Services Research Unit, University of Aberdeen, Scotland, UK.
  3. N Lois: Centre for Vision and Vascular Science, Queen's University Belfast, Belfast, UK.
  4. A Elders: Glasgow Caledonian University, Glasgow, UK.
  5. C Fraser: Health Services Research Unit, University of Aberdeen, Scotland, UK.
  6. W Amoaku: University of Nottingham, Nottingham, UK.
  7. J M Burr: University of St Andrews, St Andrews, UK.
  8. A J Lotery: University of Southampton, Southampton, UK.
  9. C R Ramsay: Health Services Research Unit, University of Aberdeen, Scotland, UK.
  10. A Azuara-Blanco: Centre for Vision and Vascular Science, Queen's University Belfast, Belfast, UK.
PMID: 25233820 DOI: 10.1038/eye.2014.214

Abstract

The purpose is to study the diagnostic performance of optical coherence tomography (OCT) and alternative diagnostic tests for neovascular age-related macular degeneration (nAMD). Methods employed are as follows:systematic review and meta-analysis;
INDEX TEST: OCT including time-domain (TD-OCT) and the most recently developed spectral domain (SD-OCT); comparator tests: visual acuity, clinical evaluation (slit lamp), Amsler chart, colour fundus photographs, infra-red reflectance, red-free images/blue reflectance, fundus autofluorescence imaging (FAF), indocyanine green angiography (ICGA), preferential hyperacuity perimetry (PHP), and microperimetry; reference standard: fundus fluorescein angiography. Databases searched included MEDLINE, MEDLINE In Process, EMBASE, Biosis, SCI, the Cochrane Library, DARE, MEDION, and HTA database. Last literature searches: March 2013. Risk of bias assessed using QUADAS-2. Meta-analysis models were fitted using hierarchical summary receiver operating characteristic (HSROC) curves. Twenty-two studies (2 abstracts and 20 articles) enrolling 2124 participants were identified, reporting TD-OCT (12 studies), SD-OCT (1 study), ICGA (8 studies), PHP (3 studies), Amsler grid, colour fundus photography and FAF (1 study each). Most studies were considered to have a high risk of bias in the patient selection (55%, 11/20), and flow and timing (40%, 8/20) domains. In a meta-analysis of TD-OCT studies, sensitivity and specificity (95% CI) were 88% (46-98%) and 78% (64-88%), respectively. There was insufficient information to undertake meta-analysis for other tests. TD-OCT is a sensitive test for detecting nAMD, although specificity was only moderate. Data on SD-OCT are sparse. Diagnosis of nAMD should not rely solely on OCT.

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Grants

  1. 10/57/22/Department of Health
  2. NMAHP2/Chief Scientist Office

MeSH Term

Coloring Agents
Diagnostic Techniques, Ophthalmological
Fluorescein Angiography
Humans
Indocyanine Green
Sensitivity and Specificity
Tomography, Optical Coherence
Visual Acuity
Wet Macular Degeneration

Chemicals

Coloring Agents
Indocyanine Green
Journal Article Meta-Analysis Research Support, Non-U.S. Gov't Review Systematic Review
Article has an altmetric score of 1

Word Cloud

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