[Clinical utility of optical coherence tomography angiography in exudative age-related macular degeneration management]
Maesa Márquez JM, Baños-Álvarez E, Rosario-Lozano MP, Blasco-Amaro JA
Record ID 32018002426
Spanish
Original Title:
Utilidad clínica de la angiografía por tomografía de coherencia óptica en el manejo de la degeneración macular asociada a la edad neovascular. Revisión sistemática y metanálisis
Authors' objectives:
To evaluate the effectiveness and safety of optical coherence tomography
angiography in the identification of choroidal neovasculature in age-related
macular degeneration versus fluorescein angiography.
Authors' results and conclusions:
Eight papers, seven primary studies and a clinical practice guide were
included. The quality of evidence was good. The total population included
in the meta-analysis was 553 eyes, with a cumulative sensitivity of 85.9 %
(95 % confidence interval, CI, 81.9 - 89.3 %), cumulative specificity of 89 %
(95 % CI, 83.5 - 93.2 %), cumulative positive and negative likelihood ratios
of 8.36 and 0.15, respectively (95 % CI from 3.05 - 22.890 and 0.09 - 0.24,
respectively) and a cumulative diagnostic odds ratio of 67.21 % (95 % CI
from 22.58 - 200.05).
Retrieved evidence does not demonstrate the superiority of OCTA over
fluorescein angiography in the identification of choroidal neovasculature
related to AMD. However, its use as a support technique could help in the
diagnosis, treatment and follow-up of the disease, and decrease the number of
angiographies that patients have to undergo. More evidence is needed to
determine the validity of the method in treated and untreated populations.
Authors' methods:
A systematic literature search was conducted in the following reference
databases up to March 2020: Medline, EMBASE, Web of Science, Cochrane
Library and Centre for Reviews and Dissemination. Alert systems were
activated in all reference databases to ensure the inclusion of relevant studies in
the analysis until the publication of the report. In addition, a manual review of
the websites of national and international health technology assessment
agencies was conducted, as well as a secondary review of selected articles. We
selected studies comparing OCTA versus flourescein angiography for the
diagnosis of choroidal neovasculature due to AMD in which data regarding the
diagnostic validity of the test (sensitivity, specificity, predictive values and
likelihood ratios) or the data necessary for its calculation were included. The
QUADAS-2 tool was used for the quality assessment. Quantitative analysis of
the results was performed by a meta-analysis. Selection, critical analysis and risk
of bias assessment, as well as data extraction was done in pairs, resolving
discrepancies by discussion and consensus.
Details
Project Status:
Completed
Year Published:
2021
URL for published report:
https://www.aetsa.org/download/02_2019_AETSA_Angio_DEF_NIPOentramite.pdf
Requestor:
Spanish Health Ministry
English language abstract:
An English language summary is available
Publication Type:
Full HTA
Country:
Spain
MeSH Terms
- Wet Macular Degeneration
- Fluorescein Angiography
- Tomography, Optical Coherence
Keywords
- Angiography
- Macular Degeneration
- Tomography
- Optical Coherence
Contact
Organisation Name:
Andalusian Health Technology Assessment Area
Contact Address:
Area de Evaluacion de Tecnologias Sanitarias Sanitarias de Andalucia (AETSA) Avda. Innovación, s/n Edificio Arena 1. Sevilla (Spain) Tel. +34 955 006 309
Contact Name:
aetsa.csalud@juntadeandalucia.es
Contact Email:
aetsa.csalud@juntadeandalucia.es
Copyright:
Andalusian Agency for Health Technology Assessment (AETSA)
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.