Diagnostic Value Of OCTA In Primary Glaucoma:A Meta-analysis

Objective Under the guidance of Evidence-based Medicine Theory,a variety of parameters related to retinal blood flow mechanism and systematic evaluation of diagnostic efficiency of optical coherence tomography angiography were applied in primary glaucoma.A meta analysis aiming to explore the parameters with high diagnostic efficiency and an effective examination method were done in this study,which laid a foundation for glaucoma diagnosis.Method The PUBMED?Cochrane Library?EMBASE?Wanfang Database?VIP?and Chinese Biomedical document Service system were included in this research.All diagnostic tests and extract relevant data and information were analyzed in Revman5.3 Software Diagnostic Test quality Evaluation tool QUADAS-2 in order to evaluate the quality of included documents.The Meta-disc1.4 software was used to analyze the extracted data,obtain the combined sensitivity?specificity?positive likelihood ratio?negative likelihood ratio and diagnostic ratio,and draw the summary receiver operating characteristic curve.Result Nine studies were included in the final research.Statistical analysis using random effect model showed sensitivity and specificity were respectively 0.59(0.55,0.63)and 0.95(0.92,0.97),positive likelihood ratio and negative likelihood ratio were respectively 9.64(6.52,14.25)and 0.39(0.31,0.51),DOR was 29.36(15.31,56.3),and AUC was 0.9119 in the measurement of optic disc peripapillary vessel density,while sensitivity and specificity were respectively 0.44(0.39,0.5)and 0.93(0.89,0.96),positive likelihood ratio and negative likelihood ratio were respectively 5.65(3.46,9.25)and 0.6(0.45,0.81),DOR was 13.07(4.58,37.27),and AUC was 0.8523 in the measurement of vessel density within the optic disc.Conclusion OCTA examination takes a short time,does not produce allergic reaction without dye injection,,and can objectively and clearly display the blood flow images and data information of all layers of the retina.The measurement of peripapillary vessel density by OCTA is effective in the diagnosis of primary glaucoma.However,with a high false negative rate,it can not be used for the screening of glaucoma.The AUC of vessel density within the optic disc by OCTA is still good though lower than that of peripapillary vessel density.Combined with the other analyzed data,it can only be used as a general examination index for glaucoma.