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

Optical coherence tomography for the diagnosis of neovascular age-related macular degeneration: a systematic review
Optical coherence tomography for the diagnosis of neovascular age-related macular degeneration: a systematic review
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.
0950-222X
1399-1406
Castillo, M.M.
73610d72-f917-4947-a200-3ae9b22d408d
Mowatt, G.
09b576b1-3fae-4ee5-9597-01180e83ed97
Lois, N.
b3df9ef4-9458-4d97-bfc9-7fa4d95b33a6
Elders, A.
813c1d4c-3e86-4088-a619-7cab26ff5621
Fraser, C.
23ca8de1-47fe-4a76-aeea-93ed6e37e8f7
Amoaku, W.
0138eb63-d27c-4a56-b51a-bcab50efef06
Burr, J.M.
bafa81df-b20a-4c20-b63c-736b995f2def
Lotery, A.J.
5ecc2d2d-d0b4-468f-ad2c-df7156f8e514
Ramsay, C.R.
27f5d17f-d99d-4d8e-9313-a6490cb9396e
Azuara-Blanco, A.
0cf430c0-1551-486b-b678-9d69e65fb9ee
Castillo, M.M.
73610d72-f917-4947-a200-3ae9b22d408d
Mowatt, G.
09b576b1-3fae-4ee5-9597-01180e83ed97
Lois, N.
b3df9ef4-9458-4d97-bfc9-7fa4d95b33a6
Elders, A.
813c1d4c-3e86-4088-a619-7cab26ff5621
Fraser, C.
23ca8de1-47fe-4a76-aeea-93ed6e37e8f7
Amoaku, W.
0138eb63-d27c-4a56-b51a-bcab50efef06
Burr, J.M.
bafa81df-b20a-4c20-b63c-736b995f2def
Lotery, A.J.
5ecc2d2d-d0b4-468f-ad2c-df7156f8e514
Ramsay, C.R.
27f5d17f-d99d-4d8e-9313-a6490cb9396e
Azuara-Blanco, A.
0cf430c0-1551-486b-b678-9d69e65fb9ee

Castillo, M.M., Mowatt, G., Lois, N., Elders, A., Fraser, C., Amoaku, W., Burr, J.M., Lotery, A.J., Ramsay, C.R. and Azuara-Blanco, A. (2014) Optical coherence tomography for the diagnosis of neovascular age-related macular degeneration: a systematic review. Eye, 28 (12), 1399-1406. (doi:10.1038/eye.2014.214). (PMID: 25233820)

Record type: Article

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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More information

Accepted/In Press date: 12 August 2014
e-pub ahead of print date: 19 September 2014
Published date: 28 December 2014
Organisations: Faculty of Medicine

Identifiers

Local EPrints ID: 390427
URI: http://eprints.soton.ac.uk/id/eprint/390427
ISSN: 0950-222X
PURE UUID: a5bdca08-d59f-4d64-9811-0ae52d7fcfb8
ORCID for A.J. Lotery: ORCID iD orcid.org/0000-0001-5541-4305

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Date deposited: 01 Apr 2016 14:32
Last modified: 03 Dec 2019 01:50

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Contributors

Author: M.M. Castillo
Author: G. Mowatt
Author: N. Lois
Author: A. Elders
Author: C. Fraser
Author: W. Amoaku
Author: J.M. Burr
Author: A.J. Lotery ORCID iD
Author: C.R. Ramsay
Author: A. Azuara-Blanco

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