Optical coherence tomography versus stereoscopic fundus photography or biomicroscopy for diagnosing diabetic macular edema: a systematic review.

摘要: PURPOSE. To review systematically the sensitivity and specificity of optical coherence tomography (OCT) for diagnosing macular edema attributable to diabetic retinopathy compared with well-established gold standard tests such as fundus stereophotography or contact noncontact biomicroscopy. METHODS. Medline Embase were searched electronically six major ophthalmic journals from 1998 2006 hand searched. Two reviewers independently assessed trial searches, studied quality QUADAS (Quality Assessment Diagnostic Accuracy Studies) checklist, extracted data. The target disease was clinically significant (CSME) according Early Treatment Diabetic Retinopathy Study (ETDRS) criteria. A bivariate model used obtain summary estimates fit a receiver operating characteristic (ROC) curve. RESULTS. Fifteen studies considered eligible. These good most items but did not report masking examiners describe how withdrawals undetermined results treated. Seven included healthy control subjects, which could have artificially enhanced OCT diagnostic performance. All one study both eyes patients without taking into account within-subject correlation in statistical analyses. Sensitivity data be only 6 15 studies, because appropriate cross tabulations index reference reported by others. In five these central retinal thickness cutoffs between 230 300 m adopted define abnormal type CSME only, whereas complex algorithm accounting extrafoveal used. design case‐control excluded meta-analysis. expected point on ROC, pooled estimate all corresponded 0.79 (95% CI: 0.71‐0.86), 0.88 0.80‐0.93), positive likelihood ratio 6.5 4.0‐10.7), negative 0.24 0.17‐0.32). values suggest overall performance CSME. CONCLUSIONS. performs well biomicroscopy diagnose edema. reporting should improved, authors present test results. Data adjusted also provided, although this issue represents challenge systematic reviewers. (Invest Ophthalmol Vis Sci. 2007; 48:4963‐4973) DOI:10.1167/iovs.06-1472