Data_Sheet_1_Diagnostic Value of Spectral-Domain Optical Coherence Tomography for Polypoidal Choroidal Vasculopathy: A Systematic Review and Meta-Analysis.docx

PurposeTo evaluate the diagnostic value of spectral-domain optical coherence tomography (SD-OCT) for polypoidal choroidal vasculopathy (PCV).
MethodsA search of electronic databases was conducted from 2010 to 2021 to review the relevant literature on SD-OCT to identify PCV and other lesions causing serious or serosanguinous retinal pigment epithelial detachment (PED), specifically neovascular age-related macular degeneration (nvAMD). The QUADAS-2 scale was used to evaluate the quality of the literature. We performed a meta-analysis, including heterogeneity tests, analyze and synthesize the study data, meta-regression analysis, subgroup analysis, Fagan's plot, sensitivity analysis and publication bias tests.
ResultsA total of 12 related studies involving 1,348 eyes were included in this study, and the random-effects model was used for meta-analysis. The results showed that the pooled sensitivity of SD-OCT in the diagnosis of PCV was 0.87 (95% CI: 0.84–0.89), the pooled specificity was 0.83 (95% CI: 0.80–0.86), and the pooled positive/negative likelihood ratios were 5.38 (95% CI: 3.28–8.80) and 0.16 (95% CI: 0.10–0.25), respectively. The diagnostic odds ratio (DOR) was 36.07 (95% CI: 15.98–81.40), and the area under the sROC curve (AUC) was 0.9429. When the pre–test probability was set at 20%, the post-test positive and negative probabilities were 58% and 4%, respectively. Meta-regression indicated that race was the primary source of heterogeneity (P <0.05). The Deeks' funnel plot showed no significant publication bias in this study (P>0.05).
ConclusionSD-OCT has high sensitivity and specificity for the diagnosis of PCV, as well as significant clinical applicability. Since color fundus photography (CFP) is more clinically available and can improve the diagnostic efficacy, we recommend SD-OCT combined with CFP to diagnose PCV, especially without indocyanine green angiography (ICGA).
Systematic Review Registrationhttps://inplasy.com/inplasy-2021-12-0048/, identifier: INPLASY2021120048.

研究目的
本研究旨在评估光谱域光学相干断层扫描（spectral-domain optical coherence tomography, SD-OCT）对息肉状脉络膜血管病变（polypoidal choroidal vasculopathy, PCV）的诊断价值。

研究方法
检索2010年至2021年的电子数据库，梳理关于SD-OCT鉴别PCV及其他引发浆液血性视网膜色素上皮脱离（serosanguinous retinal pigment epithelial detachment, PED）的病变（尤其是新生血管性年龄相关性黄斑变性（neovascular age-related macular degeneration, nvAMD））的相关文献。采用QUADAS-2量表对文献质量进行评价。本研究开展了荟萃分析，包括异质性检验、研究数据的分析与整合、Meta回归分析、亚组分析、Fagan图、敏感性分析及发表偏倚检验。

研究结果
本研究共纳入12项相关研究，涉及1348只患眼，采用随机效应模型进行荟萃分析。结果显示，SD-OCT诊断PCV的合并灵敏度为0.87（95%置信区间：0.84–0.89），合并特异度为0.83（95%置信区间：0.80–0.86），合并阳性似然比与阴性似然比分别为5.38（95%置信区间：3.28–8.80）与0.16（95%置信区间：0.10–0.25）。诊断比值比（diagnostic odds ratio, DOR）为36.07（95%置信区间：15.98–81.40），综合受试者工作特征曲线（summary receiver operating characteristic, sROC）下面积（AUC）为0.9429。当验前概率设定为20%时，阳性验后概率与阴性验后概率分别为58%与4%。Meta回归结果显示，种族是异质性的主要来源（P<0.05）。Deeks漏斗图结果显示本研究无显著发表偏倚（P>0.05）。

研究结论
SD-OCT对PCV具有较高的诊断灵敏度与特异度，具备良好的临床应用价值。鉴于彩色眼底照相（color fundus photography, CFP）临床可及性更高，且可提升诊断效能，我们推荐SD-OCT联合CFP用于PCV的诊断，尤其是在无法开展吲哚菁绿血管造影（indocyanine green angiography, ICGA）的场景下。

系统评价注册信息：系统评价注册网址为https://inplasy.com/inplasy-2021-12-0048/，标识符为INPLASY2021120048。