Moradi Yousef, Moradkhani Asra, Pourazizi Mohsen, Rezaei Leila, Azami Mobin
Social Determinant of the Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran.
Student Research Committee, Kurdistan University of Medical Sciences Sanandaj, Iran.
Med J Islam Repub Iran. 2023 Apr 15;37:38. doi: 10.47176/mjiri.37.38. eCollection 2023.
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.
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.
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%).
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.
不同设备在青光眼诊断中的准确性各不相同，因此选择最佳设备具有挑战性。因此，本研究旨在评估成像设备在青光眼诊断中的敏感性和特异性，并探讨是否需要对这一问题进行更新的荟萃分析。
在这项系统评价和荟萃分析中，检索了PubMed、Scopus和Web of Science数据库中2004年1月至2022年发表的文章。选择横断面研究或诊断性研究，并测量敏感性、特异性、阳性预测值和阴性预测值。
共纳入28项横断面研究进行荟萃分析。根据视神经区域和黄斑区域将设备分为两组。对于神经区域，合并敏感性为77%（95%CI，70-83；I2，90.01%），合并特异性为89%（95%CI，84-92，I2，93.22%）；对于黄斑区域，合并敏感性为87%（95%CI，80-92，I2，91.79%），合并特异性为90%（95%CI，84-94；I2，86.30%）。我们分别分析了每种设备。对于光学相干断层扫描（OCT），合并敏感性为85%（95%CI，81-89；I2，87.82%），合并特异性为89%（95%CI，85-92；I2，84.39%）；对于海德堡视网膜断层扫描（HRT），合并敏感性为72%（95%CI，57-83；I2，88.94%），合并特异性为79%（95%CI，62-90；I2，98.61%）；对于光学相干断层扫描血管造影（OCTA），合并敏感性为82%（95%CI，66-91；I2，93.71%），合并特异性为93%（95%CI，87-96；I2，64.72%）。
黄斑区域比视神经乳头更敏感和特异。此外，与其他成像设备相比，OCT具有更高的敏感性，OCTA具有更高的特异性。
