光学相干断层扫描血管成像诊断湿性年龄相关性黄斑变性的meta分析

Meta-analysis on diagnosis accuracy of wet age-related macular degeneration by optical coherence tomography angiography

目的系统评价光学相干断层扫描血管成像诊断湿性年龄相关性黄斑变性(wAMD)的准确性。方法全面检索Pubmed、Embase、Web of Science、Cochrane Library、万方、中国知网相关文献数据库,检索时间均为建库至2018年3月30日,检索语言不限。依据纳入及排除标准筛选文献,采用QUADAS-2工具对纳入文献进行质量评价,使用Review Manager5.2和metadisc1.4软件进行meta分析。结果总共有7篇文献纳入研究,共643只眼,与金标准荧光素钠眼底血管造影相比,光学相干断层扫描血管成像诊断wAMD合并灵敏度为0.84(95%可信区间0.80～0.87),合并特异度为0.89(95%可信区间0.84～0.93),合并阳性似然比7.98(95%可信区间3.35～19.05),合并阴性似然比0.18(95%可信区间0.12～0.27),合并诊断比值比47.53(95%可信区间17.41～129.74),SROC曲线下面积为0.9207。结论光学相干断层扫描血管成像在诊断wAMD有较高的灵敏度及特异度,可用于w AMD的诊断及病情随访。

OBJECTIVE To evaluate the diagnosis accuracy of optical coherence tomography angiography on wet age-related macular degeneration. METHODS We performed comprehensive literature searches in Pubmed, Embase, Web of Science, Cochrane Library,Wanfang Database, CNKI database update to March 30th 2018 without language limitation. We selected studies according to selection criteria and exclusion criteria, then reviewed all selected studies for methodological quality according to the QUADAS-2. The data were analyzed by the Review Manager 5.2 and metadisc 1.4. RESULTS Seven studies （643 eyes） met the inclusion criteria in the meta-analysis. Compared with the fluorescein angiography, meta-analysis showed the combined sensitivity, the combined specificity, the combined positive likelihood ratio, the combined negative likelihood ratio, combined diagnostic odds ratio, area under the curve of SROC of optical coher- ence tomography angiography were 0.84（95%CI 0.80-0.87） ,0.89（95%CI 0.84-0.93）, 7.98（95% CI 3.35-19.05）,0.18 （95%CI 0.12-0.27）,47.53 （95%CI 17.41-129.74）,0.9207 respectively. CONCLUSIONS Optical coherence tomography angiography showed high sensitivity and specificity in diagnosis of wet age-related macular degeneration, which could be used in diagnosis and follow up for wet age-related macular degeneration .