Optical coherence tomography for glaucoma diagnosis: An evidence based meta-analysis

Area of Science:

• Ophthalmology
• Medical Imaging
• Diagnostic Technology

Background:

• Early detection of glaucomatous optic neuropathy is crucial for preventing vision loss.
• Optical coherence tomography (OCT) is a key technology for monitoring retinal changes.

Purpose of the Study:

• To compare the diagnostic accuracy of five commercially available OCT devices for glaucoma.
• To evaluate the performance of different OCT scan types (RNFL, macula) in glaucoma diagnosis.

Main Methods:

• A meta-analysis of 150 studies was conducted, including data from 16,104 glaucomatous and 11,543 normal eyes.
• Searched MEDLINE, EMBASE, CINAHL, Cochrane Library, Web of Science, and BIOSIS for relevant studies.
• Pooled area under the receiver operating characteristic curve (AUROC) estimates were calculated for each device and scan type.

Main Results:

• AUROC for glaucoma diagnosis was 0.897 for RNFL average, 0.885 for macula ganglion cell complex (GCC), and 0.858 for macula ganglion cell inner plexiform layer (GCIPL).
• Total macular thickness showed a lower AUROC of 0.795.
• Diagnostic accuracy was higher in patients with more severe glaucoma.

Conclusions:

• All five OCT devices demonstrated similar glaucoma classification capabilities.
• RNFL and segmented macular scans (GCIPL, GCC) offer superior diagnostic accuracy compared to total macular thickness.
• Findings provide guidance for clinicians in selecting OCT devices for glaucoma diagnosis.