[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
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.
Project Status: Completed
Year Published: 2021
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
  • Angiography
  • Macular Degeneration
  • Tomography
  • Optical Coherence
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.