Diagnostic accuracy of OCTA and OCT for myopic choroidal neovascularisation: a systematic review and meta-analysis - Eye
Source : https://www.nature.com/articles/s41433-022-02227-8
Learning Objectives Upon completion of this activity, participants will be able to: 1. Describe test accuracy, pooled sensitivity and pooled specificity of optical coherence tomography angiography (OCTA) and spectral domain (SD)-OCT in diagnosing myopic choroidal neovascularization (mCNV) compared with fluorescein angiography (FA) as the reference standard, according to a meta-analysis.
Conclusions: OCTA can reliably diagnose mCNV in clinically suspected patients, however, SD-OCT may not reliably establish a positive diagnosis of mCNV. Future large, prospective studies with improvements in conduct and reporting are needed to strengthen these clinical recommendations.
• Source: Eye
• Relevance: “The purpose of this project was to systematically review and meta-analyse studies assessing the diagnostic accuracy of optical coherence tomography angiography (OCTA) and optical coherence tomography (OCT) for myopic choroidal neovascularisation (mCNV). Fluorescein angiography (FA) was accepted as the reference standard.”
• Based on the results, the researchers made a conditional recommendation to bolster the use of OCTA as an initial test for mCNV. This recommendation is “conditional” due to a high number of OCTA images of subpar quality assessed that could not lead to a positive or negative diagnosis. In total, studies assessed ruled out 25% of patients from analysis based on image-quality issues.
• OCTA often results in motion and projection artifacts because many patients had poor fixation due to myopic maculopathy.
• “A weaker ‘suggestion to consider’ SD-OCT was made because pooled specificity could not be estimated,” the authors wrote. “Reliance on SD-OCT alone to diagnose mCNV may result in an excessively high false positive rate leading to unnecessary over-treatment. Nevertheless, we suggest SD-OCT could be considered when an OCTA image of sufficient quality cannot be acquired.”