Diagnostic accuracy of optical coherence tomography angiography in the detection of neovasculature in age-related macular degeneration: a meta-analysis

Abstract

This work is a systematic review and meta-analysis to evaluate the diagnostic accuracy of optical coherence tomography angiography (OCTA) in the identification of choroidal neovascularization due to age-related macular degeneration (AMD) in comparison with fluorescein angiography (FA). A systematic search of the literature was carried out on Medline, EMBASE, Web of Science, Cochrane Library and Center for Reviews and Dissemination. Studies comparing OCTA with FA for the diagnosis of choroidal neovascularization due to AMD that included data on the diagnostic validity of the test or the data necessary for its calculation were selected. The QUADAS-2 tool was used to assess the risk of bias in selected studies. The quantitative analysis of the results was performed by meta-analysis. Seven primary studies were included. The quality of the evidence was good. The total population included in the meta-analysis comprised 553 eyes, with a cumulative sensitivity and specificity of 85.9% (95% CI 81.9–89.3%) and 89% (95% CI 83.5–93.2%), respectively, cumulative positive and negative likelihood ratios of 8.36 and 0.15, respectively (95% CI of 3.05–22.890 and 0.09–0.24, respectively), and a cumulative diagnostic odds ratio of 67.21 (95% CI 22.58–200.05). The evidence obtained does not demonstrate the superiority of OCTA over FA. Its use as a support technique could improve patient flow and reduce the number of FA.