Journal of Ophthalmology

Research Article

Detection Rate and Diagnostic Value of Optical Coherence Tomography Angiography in the Diagnosis of Polypoidal Choroidal Vasculopathy: A Systematic Review and Meta-Analysis

Table 1

Characteristics of included studies.
StudyType of studyDiagnostic testOCTAType of OCTAScanning rangeSegmentationCountryInclusion criteriaExclusion criteriaAgeMale (%)PCV (ICGA) (n)Treated PCV (%)
Huang et al. [29]RetrospectiveYOptovue AngioVueSD3 × 3ManualTaiwan, ChinaThe diagnosis of PCV by ICGA and received OCTA simultaneouslyPolyps beyond a 3 × 3 mm area from the central macula, other causes of fundus neovascularization67.5 ± 7.368.005042.0
Cheung et al. [1]ProspectiveYOCT (Spectralis; Heidelberg), OCTA only (Topcon DRI OCT Triton), OCT + OCTASS6 × 6ManualSingapore53 consecutive patients who presented with treatment-naive exudative AMDChoroidal neovascularization secondary to causes other than AMD69.5 ± 8.1465.20230.0
de Carlo et al. [11]RetrospectiveYCarl Zeiss Meditec AngioplexSDNAManualHawaiiEyes with AMD (both PCV and non-PCV subtypes) with structural en face OCT or OCTA imagingEyes with concomitant retinal diseases, previous focal laser, major trauma, or intraocular surgery, AMD lesions outside of the imaging areaNA87.5041NA
Peiretti et al. [12]RetrospectiveNOptovue AngioVueSD3 × 3ManualItalyPCV secondary to CSC based on clinical and multimodal imaging (FP, FFA, ICGA)Relevant opacities of the optic media, low-quality images obtained with OCTA, previous treatments, presence of other concomitant ocular diseases, poor-quality images67.35 ± 11.9655.00200.0
Chan et al. [13]ProspectiveNOptovue AngioVueSD3 × 3/6 × 6AutoChinaConfirmation of the diagnosis of PCVDetectable BVNs without any polypoidal lesion detected on the ICGA, images of OCTA with a strength signal index lower than 5061.1 ± 7.661.29320.0
Mao et al. [14]RetrospectiveNOptovue AngioVueSD3 × 3/6 × 6ManualChinaElevated orange-red lesions on fundus examination, and/or polypoidal lesions on ICGAPoor-quality OCT images due to cataract or poor fixation, choroidal neovascularization secondary to causes other than AMDNANA14NA
Lin and Shi [30] RetrospectiveNOptovue AngioVueSDNANAChinaOrange-red lesions on fundus examination, and/or polypoidal lesions on ICGARelevant opacities of the optic media, low-quality images obtained with OCTA, a history of trauma, previous treatments, presence of other concomitant ocular diseasesNANA48NA
Rebhun et al. [15]ProspectiveNPrototype SS-OCT + OCTA VISTASS3 × 3/6 × 6ManualNew EnglandConfirmed diagnosis of PCV by ICGANA71 ± 1028.57714.3
Takayama et al. [27]ProspectiveNOptovue AngioVueSD3 × 3AutoJapanEarly subretinal ICGA hyperfluorescenceEyes with >25 and <22 mm axial length, polyp outside of the scanning area, any other retinal pathology, previously been treated, unclear images73.8 ± 9.871.43210.0
Huang et al. [17]RetrospectiveNOptovue AngioVueSDNAManualTaiwan, ChinaPresence of polyps with or without BVNs on ICGAHistory of treatment including PDT or intravitreal injections of anti-VEGF therapyNANA310.0
Chi et al. [18]ProspectiveNOptovue AngioVueSD3 × 3ManualTaiwan, ChinaPolyp-like choroidal vessel dilatation with a BVN on ICGAAffected by any other macular disorders, and a history of other macular abnormalities related to diabetic retinopathy, retinal vein occlusion, uveitis, etc.68.9 ± 8.0NA4748.9
de Carlo et al. [19]RetrospectiveNCarl Zeiss Meditec AngioplexSDNAManualAsian, Filpino, CaucasianDiagnosed with PCV using ICGAEyes with other concomitant retinal diseases including diabetic retinopathy, artery and vein occlusion, and macular telangiectasia77 (53–92)51.064785.1
Xu and Lin [20]RetrospectiveNAngio-retinaSD6 × 6ManualChinaElevated orange-red lesions on fundus examination, and/or polypoidal lesions on ICGACombined with pathologic myopia, or a history of surgery or trauma66.03 ± 8.1470.0020NA
Tanaka et al. [16]RetrospectiveNOptovue AngioVueSD3 × 3/6 × 6ManualJapanPresence of polypoidal lesions on ICGA, categorized into polypoidal CNV (type 1 PCV) or typical PCV (type 2 PCV)NANA75.00320.0
Cheung et al. [21]ProspectiveYTopcon DRI OCT TritonSS3 × 3ManualSingaporeDiagnosis of PCV based on clinical examination and underwent FFA and ICGANA68.89 ± 9.4163.005468.5
Tomiyasu et al. [22]RetrospectiveNOptovue AngioVueSD6 × 6ManualJapanDiagnosis of treatment-naive PCV, based on ophthalmoscopic examinations, ICGA, and OCTPoor-quality OCT images due to cataract or poor fixation71.85 ± 9.5390.00200.0
Wang et al. [23]RetrospectiveNOptovue AngioVueSD3 × 3ManualChinaDiagnosis of PCV by FP, FFA, ICGA, SD-OCTA large area of hemorrhage or cloudy media that could significantly reduce the intensity of the OCTA signal59.3 ± 5.4384.621315.4
Kim et al. [24]RetrospectiveNOptovue AngioVueSD3 × 3/6 × 6ManualKoreaHyperfluorescent polyps detected by ICGACases accompanied by severe subretinal hemorrhage and scarring show inaccurate segmentations67.86 ± 14.0271.43771.4
Srour et al. [25]ProspectiveNOptovue AngioVueSD3 × 3AutoFranceDiagnosis of PCV based on FP, FFA, ICGA, SD-OCTAffected with any other macular disorders such as high myopia (>8 diopters), presence of angioid streaks, or intraocular inflammation72.6 ± 10.533.331283.3
Inoue et al. [26]RetrospectiveNOptovue AngioVue/Heidelberg Spectralis OCTASD3 × 3ManualUSDemonstrated polypoidal changes to neovascular tissue on ICGA and SD-OCTNA71.1 ± 10.914.29785.7
Ma et al. [28]RetrospectiveNOptovue AngioVueSD6 × 6AutoChinaElevated orange-red lesions on fundus examination/polypoidal lesions on ICGACombined with pathologic myopia, idiopathic choroidal neovascularization, history of surgery or trauma, low vision that cannot complete OCTA exam68.24 ± 6.8052.94170.0
OCTA: optical coherence tomography angiography; SD: spectral domain; SS: swept source; PCV: polypoidal choroidal vasculopathy; ICGA: indocyanine green angiograph; FFA: fundus fluorescein angiography; FP: fundus photograph; wAMD: wet age-related macular degeneration; PDT: photodynamic therapy; VEGF: vascular endothelial growth factor; CNV: choroidal neovascularization; NA: not available; Y: yes; N: no.