Diagnostic value of optical coherence tomography angiography in primary open-angle glaucoma: a meta-analysis_Chinese Journal of Evidence-Based Medicine

Authors：

BAI Rong ¹ , ZHAO Yu ¹ , HAO Hongyan ¹ , CHEN Weibai ¹ , LI Sheng ¹ , TIAN Chen ² ,  LI Jun ¹

1. Fifth Department of Ophthalmology, The First People’s Hospital of Lanzhou City, Lanzhou 730000, P. R. China;
2. Department of Health Policy and Management, School of Public Health, Lanzhou University, Lanzhou 730000, P. R. China;

Corresponding?author：

LI Jun, Email: 13919176578@163.com

Keywords：

Optical coherence tomography angiography; Primary open-angle glaucoma; Diagnostic test accuracy study; Meta-analysis; Systematic review

DOI：

10.7507/1672-2531.202404126

Video：

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Objective To systematically review the diagnostic value of optical coherence tomography angiography (OCTA) for primary open-angle glaucoma (POAG). Methods The CNKI, WanFang Data, VIP, CBM, PubMed, Embase, Web of Science, and Cochrane Library databases were electronically searched to collect diagnostic test on OCTA for POAG from inception to February 2024. Two reviewers independently screened literature, extracted data and assessed the risk of bias of the included studies. Meta-analysis was then performed by using Stata 15.0 software. Results A total of 12 diagnostic tests involving 993 subjects were included. Meta-analysis results showed that the sensitivity/specificity of OCTA for diagnosing peripapillary vessel density, retinal vessel density, and optic nerve fiber changes in patients with POAG were 0.77/0.92, 0.56/0.92, and 0.85/0.91, respectively, and the AUC of the SROC curve was 0.94, 0.92 and 0.95, respectively. Conclusion OCTA has high diagnostic accuracy for POAG. Due to the limited quality and quantity of the included studies, more high quality studies are needed to verify the above conclusion.

Citation： BAI Rong, ZHAO Yu, HAO Hongyan, CHEN Weibai, LI Sheng, TIAN Chen, LI Jun. Diagnostic value of optical coherence tomography angiography in primary open-angle glaucoma: a meta-analysis. Chinese Journal of Evidence-Based Medicine, 2025, 25(2): 175-179. doi: 10.7507/1672-2531.202404126 Copy

1.	Weinreb RN, Khaw PT. Primary open-angle glaucoma. Lancet, 2004, 363(9422): 1711-1720.
2.	張鑫, 楊蓉, 曾繼紅. 原發性青光眼患者自我管理行為現狀及影響因素研究. 華西醫學, 2022, 37(4): 568-574.
3.	王云, 樊寧, 劉旭陽. 原發性開角型青光眼相關基因及發病機制研究進展. 中華眼視光學與視覺科學雜志, 2019, 21(10): 796-800.
4.	田晨, 楊秋玉, 賴鴻皓, 等. 診斷性試驗準確性比較研究. 中國循證醫學雜志, 2022, 22(5): 590-594.
5.	de Carlo TE, Romano A, Waheed NK, et al. A review of optical coherence tomography angiography (OCTA). Int J Retina Vitreous, 2015, 1: 5.
6.	中華醫學會眼科學分會青光眼學組. 我國原發性青光眼診斷和治療專家共識(2014年). 中華眼科雜志, 2014, 50(5): 382-383.
7.	Whiting PF, Rutjes AW, Westwood ME, et al. QUADAS-2: a revised tool for the quality assessment of diagnostic accuracy studies. Ann Intern Med, 2011, 155(8): 529-536.
8.	曲艷吉, 楊智榮, 孫鳳, 等. 偏倚風險評估系列: (六)診斷試驗. 中華流行病學雜志, 2018, 39(4): 524-531.
9.	張恒麗, 李樹寧, 閆曉偉, 等. 分離格柵視覺誘發電位和光學相干斷層掃描血管成像術在原發性開角型青光眼早期診斷中的相關性. 眼科學報, 2020, 35(6): 405-412.
10.	Rao HL, Pradhan ZS, Weinreb RN, et al. Regional comparisons of optical coherence tomography angiography vessel density in primary open-angle glaucoma. Am J Ophthalmol, 2016, 171: 75-83.
11.	Geyman LS, Garg RA, Suwan Y, et al. Peripapillary perfused capillary density in primary open - angle glaucoma across disease stage : an optical coherence tomography angiography study. Br J Ophthalmol, 2017, 101(9): 1261-1268.
12.	Rao HL, Pradhan ZS, Weinreb RN, et al. Optical coherence tomography angiography vessel density measurements in eyes with primary open-angle glaucoma and disc hemorrhage. J Glaucoma, 2017, 26(10): 888-895.
13.	Chen A, Liu L, Wang J, et al. Measuring glaucomatous focal perfusion loss in the peripapillary retina using OCT angiography. Ophthalmology, 2020, 127(4): 484-491.
14.	Chang R, Chu Z, Burkemper B, et al. Effect of scan size on glaucoma diagnostic performance using OCT angiography en face images of the radial peripapillary capillaries. J Glaucoma, 2019, 28(5): 465-472.
15.	Rao HL, Kadambi SV, Weinreb RN, et al. Diagnostic ability of peripapillary vessel density measurements of optical coherence tomography angiography in primary open-angle and angle-closure glaucoma. Br J Ophthalmol, 2017, 101(8): 1066-1070.
16.	Tabl AA, Tabl MA. Correlation between OCT-angiography and photopic negative response in patients with primary open angle glaucoma. Int Ophthalmol, 2023, 43(6): 1889-1901.
17.	Wan KH, Lam AKN, Leung CK. Optical coherence tomography angiography compared with optical coherence tomography macular measurements for detection of glaucoma. JAMA Ophthalmol, 2018, 136(8): 866-874.
18.	Akil H, Huang AS, Francis BA, et al. Retinal vessel density from optical coherence tomography angiography to differentiate early glaucoma, pre-perimetric glaucoma and normal eyes. PLoS One, 2017, 12(2): e0170476.
19.	Akil H, Chopra V, Al-Sheikh M, et al. Swept-source OCT angiography imaging of the macular capillary network in glaucoma. Br J Ophthalmol, 2018, 102: 515-519.
20.	吳艷, 楊璐. 原發性開角型青光眼診斷的研究現狀. 國際眼科雜志, 2021, 21(9): 1552-1556.
21.	Bonomi L, Marchini G, Marraffa M, et al. Vascular risk factors for primary open angle glaucoma: the Egna-neumarkt study. Ophthalmology, 2000, 107(7): 1287-1293.
22.	吳玲玲. 如何運用OCTA助力青光眼診治. 眼科, 2023, 32(1): 1-5.
23.	楊香香, 何媛, 張堅. OCTA技術在原發性青光眼中的應用研究進展. 國際眼科雜志, 2021, 21(1): 57-61.
24.	田晨, 楊秋玉, 賴鴻皓, 等. 診斷試驗準確性比較研究的統計分析. 中國循證醫學雜志, 2022, 22(12): 1474-1482.
25.	吳宇橋. OCTA對原發性青光眼診斷價值的Meta分析. 福州: 福建醫科大學, 2018.
26.	Moradi Y, Moradkhani A, Pourazizi M, et al. Diagnostic accuracy of imaging devices in glaucoma: an updated meta-analysis. Med J Islam Repub Iran, 2023 Apr 15: 37: 38.

1. Weinreb RN, Khaw PT. Primary open-angle glaucoma. Lancet, 2004, 363(9422): 1711-1720.
2. 張鑫, 楊蓉, 曾繼紅. 原發性青光眼患者自我管理行為現狀及影響因素研究. 華西醫學, 2022, 37(4): 568-574.
3. 王云, 樊寧, 劉旭陽. 原發性開角型青光眼相關基因及發病機制研究進展. 中華眼視光學與視覺科學雜志, 2019, 21(10): 796-800.
4. 田晨, 楊秋玉, 賴鴻皓, 等. 診斷性試驗準確性比較研究. 中國循證醫學雜志, 2022, 22(5): 590-594.
5. de Carlo TE, Romano A, Waheed NK, et al. A review of optical coherence tomography angiography (OCTA). Int J Retina Vitreous, 2015, 1: 5.
6. 中華醫學會眼科學分會青光眼學組. 我國原發性青光眼診斷和治療專家共識(2014年). 中華眼科雜志, 2014, 50(5): 382-383.
7. Whiting PF, Rutjes AW, Westwood ME, et al. QUADAS-2: a revised tool for the quality assessment of diagnostic accuracy studies. Ann Intern Med, 2011, 155(8): 529-536.
8. 曲艷吉, 楊智榮, 孫鳳, 等. 偏倚風險評估系列: (六)診斷試驗. 中華流行病學雜志, 2018, 39(4): 524-531.
9. 張恒麗, 李樹寧, 閆曉偉, 等. 分離格柵視覺誘發電位和光學相干斷層掃描血管成像術在原發性開角型青光眼早期診斷中的相關性. 眼科學報, 2020, 35(6): 405-412.
10. Rao HL, Pradhan ZS, Weinreb RN, et al. Regional comparisons of optical coherence tomography angiography vessel density in primary open-angle glaucoma. Am J Ophthalmol, 2016, 171: 75-83.
11. Geyman LS, Garg RA, Suwan Y, et al. Peripapillary perfused capillary density in primary open - angle glaucoma across disease stage : an optical coherence tomography angiography study. Br J Ophthalmol, 2017, 101(9): 1261-1268.
12. Rao HL, Pradhan ZS, Weinreb RN, et al. Optical coherence tomography angiography vessel density measurements in eyes with primary open-angle glaucoma and disc hemorrhage. J Glaucoma, 2017, 26(10): 888-895.
13. Chen A, Liu L, Wang J, et al. Measuring glaucomatous focal perfusion loss in the peripapillary retina using OCT angiography. Ophthalmology, 2020, 127(4): 484-491.
14. Chang R, Chu Z, Burkemper B, et al. Effect of scan size on glaucoma diagnostic performance using OCT angiography en face images of the radial peripapillary capillaries. J Glaucoma, 2019, 28(5): 465-472.
15. Rao HL, Kadambi SV, Weinreb RN, et al. Diagnostic ability of peripapillary vessel density measurements of optical coherence tomography angiography in primary open-angle and angle-closure glaucoma. Br J Ophthalmol, 2017, 101(8): 1066-1070.
16. Tabl AA, Tabl MA. Correlation between OCT-angiography and photopic negative response in patients with primary open angle glaucoma. Int Ophthalmol, 2023, 43(6): 1889-1901.
17. Wan KH, Lam AKN, Leung CK. Optical coherence tomography angiography compared with optical coherence tomography macular measurements for detection of glaucoma. JAMA Ophthalmol, 2018, 136(8): 866-874.
18. Akil H, Huang AS, Francis BA, et al. Retinal vessel density from optical coherence tomography angiography to differentiate early glaucoma, pre-perimetric glaucoma and normal eyes. PLoS One, 2017, 12(2): e0170476.
19. Akil H, Chopra V, Al-Sheikh M, et al. Swept-source OCT angiography imaging of the macular capillary network in glaucoma. Br J Ophthalmol, 2018, 102: 515-519.
20. 吳艷, 楊璐. 原發性開角型青光眼診斷的研究現狀. 國際眼科雜志, 2021, 21(9): 1552-1556.
21. Bonomi L, Marchini G, Marraffa M, et al. Vascular risk factors for primary open angle glaucoma: the Egna-neumarkt study. Ophthalmology, 2000, 107(7): 1287-1293.
22. 吳玲玲. 如何運用OCTA助力青光眼診治. 眼科, 2023, 32(1): 1-5.
23. 楊香香, 何媛, 張堅. OCTA技術在原發性青光眼中的應用研究進展. 國際眼科雜志, 2021, 21(1): 57-61.
24. 田晨, 楊秋玉, 賴鴻皓, 等. 診斷試驗準確性比較研究的統計分析. 中國循證醫學雜志, 2022, 22(12): 1474-1482.
25. 吳宇橋. OCTA對原發性青光眼診斷價值的Meta分析. 福州: 福建醫科大學, 2018.
26. Moradi Y, Moradkhani A, Pourazizi M, et al. Diagnostic accuracy of imaging devices in glaucoma: an updated meta-analysis. Med J Islam Repub Iran, 2023 Apr 15: 37: 38.

Chinese Journal of Evidence-Based Medicine

Diagnostic value of optical coherence tomography angiography in primary open-angle glaucoma: a meta-analysis

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