Diagnostic Accuracy of Imaging Devices in Glaucoma: An Updated Meta-Analysis

Background Different devices have diverse accuracy in diagnosing glaucoma, and therefore choosing the best device is challenging. Thereby, this study was conducted to evaluate the diagnostic sensitivity and specificity of imaging devices in glaucoma and explore the need for an updated meta-analysis on this issue. Methods In this systematic review and meta-analysis, PubMed, Scopus, and Web of Science databases were searched for articles published between January 2004 and 2022. Cross-sectional or diagnostic studies were selected, and sensitivity, specificity, positive predictive value, and negative predictive value were measured. Results A total of 28 cross-sectional studies were included for meta-analysis. Devices were divided into 2 groups, based on the optic nerve area and the macular area. For the nerve area, the pooled sensitivity was 77% (CI 95%, 70-83; I2, 90.01%) and the pooled specificity was 89% (CI 95%, 84-92, I2, 93.22%), and for the macular area, the pooled sensitivity was 87% (CI 95%, 80-92, I2, 91.79%), and the pooled specificity was 90% (CI 95%, 84-94; I2, 86.30%). We analyzed each device separately. For optical coherence tomography(OCT), the pooled sensitivity was 85% (CI 95%, 81-89; I2, 87.82%) and the pooled specificity was 89% (CI 95%, 85-92; I2, 84.39%); for Heidelberg retinal tomography (HRT), the pooled sensitivity was 72% (CI 95%, 57-83; I2, 88.94%) and the pooled specificity was 79% (CI 95%, 62-90; I2, 98.61%), and for optical coherence tomography angiography (OCTA), the pooled sensitivity was 82% (CI 95%, 66-91; I2, 93.71%) and the pooled specificity was 93% (CI 95%, 87-96; I2, 64.72%). Conclusion The macular area was more sensitive and specific than the optic nerve head. Furthermore, OCT had higher sensitivity, and OCTA had higher specificity when compared with other imaging devices.

[1]  I. Stalmans,et al.  OCT-angiography detects longitudinal microvascular changes in glaucoma: a systematic review , 2021, British Journal of Ophthalmology.

[2]  Y. Moradi,et al.  Diagnostic accuracy of cerebrospinal fluid and serum-isolated extracellular vesicles for glioblastoma: a systematic review and meta-analysis , 2020, Expert review of molecular diagnostics.

[3]  Young Kook Kim,et al.  Dual-input convolutional neural network for glaucoma diagnosis using spectral-domain optical coherence tomography , 2020, British Journal of Ophthalmology.

[4]  M. Huecker,et al.  Diagnostic Testing Accuracy: Sensitivity, Specificity, Predictive Values and Likelihood Ratios , 2020 .

[5]  Zhaoxia Luo,et al.  Diagnostic power of scleral spur length in primary open-angle glaucoma , 2020, Graefe's Archive for Clinical and Experimental Ophthalmology.

[6]  L. Arnould,et al.  Accuracy of the ISNT rule and its variants for differentiating glaucomatous from normal eyes in a population-based study , 2020, British Journal of Ophthalmology.

[7]  A. Tuulonen,et al.  Diagnostic performance of modern imaging instruments in glaucoma screening , 2020, British Journal of Ophthalmology.

[8]  David Huang,et al.  Measuring Glaucomatous Focal Perfusion Loss in the Peripapillary Retina Using OCT Angiography. , 2019, Ophthalmology.

[9]  L. Pablo,et al.  Diagnostic capability of a linear discriminant function applied to a novel Spectralis OCT glaucoma-detection protocol , 2019, BMC Ophthalmology.

[10]  L. Azevedo,et al.  Diagnostic performance of optical coherence tomography angiography in glaucoma: a systematic review and meta-analysis , 2019, British Journal of Ophthalmology.

[11]  G. Holló.  Optical Coherence Tomography Angiography in Glaucoma , 2018, Turkish journal of ophthalmology.

[12]  C. Leung,et al.  Optical Coherence Tomography Angiography Compared With Optical Coherence Tomography Macular Measurements for Detection of Glaucoma , 2018, JAMA ophthalmology.

[13]  K. Park,et al.  Diagnostic Accuracy of Three-Dimensional Neuroretinal Rim Thickness for Differentiation of Myopic Glaucoma From Myopia. , 2018, Investigative ophthalmology & visual science.

[14]  João Barbosa-Breda,et al.  Optical Coherence Tomography Angiography in Glaucoma: A Review , 2018, Ophthalmic Research.

[15]  I. Rudan,et al.  National and subnational prevalence and burden of glaucoma in China: A systematic analysis , 2017, Journal of global health.

[16]  B. Vakoc,et al.  Diagnostic Capability of Peripapillary Three-dimensional Retinal Nerve Fiber Layer Volume for Glaucoma Using Optical Coherence Tomography Volume Scans. , 2017, American journal of ophthalmology.

[17]  K. Ghasemi Falavarjani,et al.  Swept-source OCT angiography imaging of the macular capillary network in glaucoma , 2017, British Journal of Ophthalmology.

[18]  Alfonso Antón,et al.  Diagnostic Accuracy of Spectralis SD OCT Automated Macular Layers Segmentation to Discriminate Normal from Early Glaucomatous Eyes. , 2017, Ophthalmology.

[19]  Alfonso Antón,et al.  Diagnostic accuracy of imaging devices in glaucoma: A meta-analysis. , 2017, Survey of ophthalmology.

[20]  Ying-xi Zhao,et al.  Diagnostic performance of isolated-check visual evoked potential versus retinal ganglion cell-inner plexiform layer analysis in early primary open-angle glaucoma , 2017, BMC Ophthalmology.

[21]  Narendra K. Puttaiah,et al.  Diagnostic ability of peripapillary vessel density measurements of optical coherence tomography angiography in primary open-angle and angle-closure glaucoma , 2016, British Journal of Ophthalmology.

[22]  J. Dartigues,et al.  Diagnostic Performance of Peripapillary Retinal Nerve Fiber Layer Thickness for Detection of Glaucoma in an Elderly Population: The ALIENOR Study. , 2016, Investigative ophthalmology & visual science.

[23]  D. Hood,et al.  A Single Wide-Field OCT Protocol Can Provide Compelling Information for the Diagnosis of Early Glaucoma , 2016, Translational vision science & technology.

[24]  Janet Leasher,et al.  Number of People Blind or Visually Impaired by Glaucoma Worldwide and in World Regions 1990 – 2010: A Meta-Analysis , 2016, PloS one.

[25]  D. Friedman,et al.  Primary open-angle glaucoma , 2016, Nature Reviews Disease Primers.

[26]  David Huang,et al.  Optical Coherence Tomography Angiography Vessel Density in Healthy, Glaucoma Suspect, and Glaucoma Eyes , 2016, Investigative ophthalmology & visual science.

[27]  M. Nicolela,et al.  Diagnostic Accuracy of Optical Coherence Tomography and Scanning Laser Tomography for Identifying Glaucoma in Myopic Eyes. , 2016, Ophthalmology.

[28]  Francesco Oddone,et al.  Macular versus Retinal Nerve Fiber Layer Parameters for Diagnosing Manifest Glaucoma: A Systematic Review of Diagnostic Accuracy Studies. , 2016, Ophthalmology.

[29]  C. Gerardi,et al.  Quality of Life in Glaucoma: A Review of the Literature , 2016, Advances in Therapy.

[30]  Eun Ji Lee,et al.  Comparison of the Abilities of SD-OCT and SS-OCT in Evaluating the Thickness of the Macular Inner Retinal Layer for Glaucoma Diagnosis , 2016, PloS one.

[31]  D. Garway-Heath,et al.  Diagnostic Accuracy of Technologies for Glaucoma Case-Finding in a Community Setting. , 2015, Ophthalmology.

[32]  M. Brazzelli,et al.  Optic nerve head and fibre layer imaging for diagnosing glaucoma. , 2015, The Cochrane database of systematic reviews.

[33]  Paaraj Dave,et al.  Diagnostic accuracy of posterior pole asymmetry analysis parameters of spectralis optical coherence tomography in detecting early unilateral glaucoma , 2015, Indian journal of ophthalmology.

[34]  Sang Hyun Choi,et al.  Systematic Review and Meta-Analysis of Studies Evaluating Diagnostic Test Accuracy: A Practical Review for Clinical Researchers-Part II. Statistical Methods of Meta-Analysis , 2015, Korean journal of radiology.

[35]  Monali S. Malvankar-Mehta,et al.  The Cost-Effectiveness Analysis of Teleglaucoma Screening Device , 2015, PloS one.

[36]  David Huang,et al.  Optical Coherence Tomography Angiography of the Peripapillary Retina in Glaucoma. , 2015, JAMA ophthalmology.

[37]  Gadi Wollstein,et al.  OCT for glaucoma diagnosis, screening and detection of glaucoma progression , 2013, British Journal of Ophthalmology.

[38]  Ki Ho Park,et al.  Macular ganglion cell imaging study: glaucoma diagnostic accuracy of spectral-domain optical coherence tomography. , 2013, Investigative ophthalmology & visual science.

[39]  Masanori Hangai,et al.  A novel method to detect local ganglion cell loss in early glaucoma using spectral-domain optical coherence tomography. , 2012, Investigative ophthalmology & visual science.

[40]  Jean-Claude Mwanza,et al.  Glaucoma diagnostic accuracy of ganglion cell-inner plexiform layer thickness: comparison with nerve fiber layer and optic nerve head. , 2012, Ophthalmology.

[41]  Hiroshi Ishikawa,et al.  Glaucoma discrimination of segmented cirrus spectral domain optical coherence tomography (SD-OCT) macular scans , 2012, British Journal of Ophthalmology.

[42]  A. Iwase,et al.  Sensitivity and specificity of the Heidelberg Retina Tomograph II Version 3.0 in a population-based study: the Tajimi Study. , 2009, Ophthalmology.

[43]  P. Kóthy,et al.  Accuracy of Scanning Laser Polarimetry, Scanning Laser Tomography, and Their Combination in a Glaucoma Screening Trial , 2008, Journal of glaucoma.

[44]  Márta Tóth,et al.  Accuracy of Combined GDx-VCC and Matrix FDT in a Glaucoma Screening Trial , 2007, Journal of glaucoma.

[45]  R. Ciuluvică,et al.  Visual evoked potential in the early diagnosis of glaucoma. Literature review , 2020, Romanian journal of ophthalmology.

[46]  P. Brusini.  OCT Glaucoma Staging System: a new method for retinal nerve fiber layer damage classification using spectral-domain OCT , 2018, Eye.

[47]  T. Yaşar,et al.  Comparison of Heidelberg Retina Tomograph-3 glaucoma probability score and Moorfields regression analysis of optic nerve head in glaucoma patients and healthy individuals , 2016, Graefe's Archive for Clinical and Experimental Ophthalmology.

[48]  E. Vesti.  [The diagnosis and treatment of glaucoma]. , 1995, Duodecim; laaketieteellinen aikakauskirja.