Individual study results

Graham Mowatt; Rodolfo Hernández; Mayret Castillo; Noemi Lois; Andrew Elders; Cynthia Fraser; Olatunde Aremu; Winfried Amoaku; Jennifer Burr; Andrew Lotery; Craig Ramsay; Augusto Azuara-Blanco

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Mowatt G, Hernández R, Castillo M, et al. Optical coherence tomography for the diagnosis, monitoring and guiding of treatment for neovascular age-related macular degeneration: a systematic review and economic evaluation. Southampton (UK): NIHR Journals Library; 2014 Dec. (Health Technology Assessment, No. 18.69.)

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Optical coherence tomography for the diagnosis, monitoring and guiding of treatment for neovascular age-related macular degeneration: a systematic review and economic evaluation.

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Appendix 6Individual study results

TABLE 46

Diagnostic studies (n = 24 reports of 22 studies)

Study ID	Test	Unit of analysis	Number analysed	TP	FP	FN	TN	Sensitivity (%)	Specificity (%)
Alster 2005²⁴	PHP	Eye/patient	122	53	7	12	50	81.5	87.7
	Colour fundus photography	Eye/patient	120	45	3	19	53	70.0	95.0
	Colour fundus photography plus VA	Eye/patient	66	10	3	9	44	53.0	94.0
Cachulo 2011²⁵	TD-OCT	Eye/patient	52	17		0		100.0	NC
	ICGA	Eye/patient	52	16		1		94.1	NC
	FAF (but not clear whether before conversion or at time of conversion so may not be usable)	Eye/patient	50	14	22	1	13	93.3	37.1
Silva 2011⁴⁷ (secondary report to Cachulo 2011²⁵)	TD-OCT	Eye/patient	52	24		0		100.0	NC
Chen 2003²⁶	ICGA	Eye
Chen 2003²⁶	ICGA	Occult CNV detection	35	22		13		62.9	NC
Do 2012²⁷	CNV defined as FFA positive by the Reading Centre irrespective of treatment decision (n = 15)
	TD-OCT	Eye/patient	87	6	21	9	51	40.0	70.8
	Amsler grid	Eye/patient	46	5	NC	7	34	41.7	N/R
	PHP	Eye/patient	49	6	NC	6	37	50.0	N/R
	CNV defined as FFA positive by the Reading Centre and the clinician recommended treatment (n = 13)
	TD-OCT	Eye/patient	87	9	25	4	49	69.2	66.2
	Amsler grid	Eye/patient	47	5	NC	5	37	50.0	N/R
	PHP	Eye/patient	45	7	NC	3	35	70.0	N/R
Fujii 1996²⁹	ICGA/DH/DS	Eye	32	11	12	2	7	84.6	36.8
Gomi 2007³¹	ICGA/DH/DS	Eye/patient
Gomi 2007³¹	ICGA/DH/DS	PCV detection	37	37	NC	0	NC	100.0	NC
Hughes 2005³³	TD-OCT	Eye/patient	22	8		14		36.4	NC
Khondkaryan 2009³⁴	TD-OCT	Eye/patient
		Detection of occult	51	30	8	7	6	81.1	42.9
		Detection of classic	51	17	13	4	17	80.9	56.7
		Detection of RAP	51	4	8	3	36	57.1	81.8
Kim 2003³⁵	TD-OCT	Eye/patient	13	12		1		92.3	NC
Kozak 2008³⁶	TD-OCT (although subset of patients received SD-OCT)	Eye	541	514	13	14	NC	97.3	NC
Krebs 2007³⁷	TD-OCT	Eye
		Primarily classic	5	5		0		100.0
		RAP	11	8		3		72.7
		Dry AMD as negative diagnosis	12		0		12		100.0
Liakopoulos 2008³⁸	TD-OCT	Eye/patient (n = 66 for both)
		Subretinal fluid
		Occult with no classic	24	19		5		79.2	NC
		Minimally classic	23	21		2		91.3	NC
		Predominantly classic	11	11		0		100.0	NC
		RAP stage III	8	4		4		50.0	NC
		All	66	55		11		83.3	NC
		Cystoid oedema
		Occult with no classic	24	14		10		58.3	NC
		Minimally classic	23	17		6		73.9	NC
		Predominantly classic	11	9		2		81.8	NC
		RAP stage III	8	8		0		100.0	NC
		All	66	48		18		72.7	NC
Loewenstein 2010³⁹	PHP	Eye/patient
		Retrospective part	77	29	7	5	36	85.3	83.7
		Prospective part	54	27	3	5	19	84.4	86.4
		All	131	56	10	10	55	84.8	84.6
Padnick-Silver 2012⁴⁰	TD-OCT	Eye/patient	77	12	4	3	58	80.0	93.5
Park 2010⁴¹	SD-OCT	Eye	21	21		0		100.0	NC
Parravano 2012⁴²	ICGA	Patient
Parravano 2012⁴²	ICGA	Detection of RAP	155	40		7		85.1	NC
Reichel 1995⁴⁴	ICGA	Eye/patient	20	16	4	0	NC	100.0	NC
Salinas-Alaman 2005⁴⁵	TD-OCT	Eye	62	60		2		96.8	NC
Sandhu 2005⁴⁶	TD-OCT	Eye	131	63	12	18	38	77.8^a	76.0^a
Sandhu 2005⁴⁶	SD-OCT + stereo colour fundus photography	Eye	131	60	4	21	46	74.1^a	92.0^a
Sulzbacher 2011⁴⁸	ICGA	Eye
Sulzbacher 2011⁴⁸	ICGA	Detection of type 2 CNV without an occult component	13	13		0		100.0	NC
Talks 2007⁴⁹	TD-OCT	Eye/patient	111	73	13	0	25	100.0	65.8
Torron 2002⁵¹	ICGA	Eye	102	94		8		92.2	NC
Torron 2001⁵⁰ (secondary report to Torron 2002⁵¹)	ICGA	Eye	56	50		6		89.3	NC

: DH, direct head-to-head comparison; DS, diagnostic study; NC, not calculable; N/R, not reported; PCV, polpoidal choroidal vasculopathy.
a: The values given for TP, FP, FN, TN and sensitivity and specificity are our calculations, not those of Sandhu and Talks.⁴⁶ Sandhu and Talks⁴⁶ reported sensitivity and specificity including serous PED as presence of nAMD. However, as a serous PED did not fall within our definition of nAMD for diagnostic studies, data presented in the paper were recalculated accordingly. The values reported by Sandhu and Talks⁴⁶ were SD-OCT, sensitivity 96.4%, specificity 66.0%; SD-OCT plus stereo colour fundus photographs, sensitivity 94.0%, specificity 89.4%.

TABLE 47

Monitoring studies (n = 8 reports of 8 studies)

Study ID	Test	Unit of analysis	Number analysed	TP	FP	FN	TN	Sensitivity (%)	Specificity (%)
Eter 2005²⁸	TD-OCT	Eye/patient	60	40	2	10	8	80.0	80.0
Giani 2011³⁰	SD-OCT	Eye/patient
		Classic CNV	57	30	15	3	9	90.9	37.5
		Occult CNV	36	19	15	0	2	100.0	11.8
		Overall CNV	93	49	30	3	11	94.2	26.8
Henschel 2009³² (14 patients; 61 pairs of OCT and FFA examinations)	TD-OCT	Examination
		CNV based on detection of intraretinal fluid	61	28	18	3	12	90.3	40.0
		CNV based on detection of subretinal fluid	61	22	8	9	22	71.0	73.3
		CNV based on detection of intraretinal and/or subretinal fluid	61	30	19	1	11	96.8	36.7
Khurana 2010²³	TD-OCT	Eye	59	17	11	12	19	58.6	63.3
Khurana 2010²³	SD-OCT	Eye	59	26	16	3	14	89.7	46.7
Regillo 1998⁴³ (54 angiogram pairs obtained from 24 eyes of 21 patients)	ICGA/DH/DS	Examination	54	22	3	7	22	75.9	88.0
Salinas-Alaman 2005⁴⁵	TD-OCT	Remark (= examination)	176	110	25	5	36	95.7	59.0
van de Moere 2006⁵²	TD-OCT	Eye/patient
		Detection of PED as criteria for positive test result	121	4	0	66	51	5.7	100.0
		Detection of subretinal fluid as positive test result	121	33	8	37	43	47.1	84.3
		Detection of intraretinal fluid as positive test result	121	58	24	12	27	82.9	52.9
		Detection of CMO as a positive test result	121	16	1	54	50	22.9	98.0
van Velthoven 2006⁵³	TD-OCT	Eye/patient	30	15	4	8	3	65.2	42.9

: CMO, cystoid macular oedema; DH, direct head-to-head comparison; DS, diagnostic study.

Copyright © Queen’s Printer and Controller of HMSO 2014. This work was produced by Mowatt et al. under the terms of a commissioning contract issued by the Secretary of State for Health. This issue may be freely reproduced for the purposes of private research and study and extracts (or indeed, the full report) may be included in professional journals provided that suitable acknowledgement is made and the reproduction is not associated with any form of advertising. Applications for commercial reproduction should be addressed to: NIHR Journals Library, National Institute for Health Research, Evaluation, Trials and Studies Coordinating Centre, Alpha House, University of Southampton Science Park, Southampton SO16 7NS, UK.

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Mowatt G, Hernández R, Castillo M, et al. Optical coherence tomography for the diagnosis, monitoring and guiding of treatment for neovascular age-related macular degeneration: a systematic review and economic evaluation. Southampton (UK): NIHR Journals Library; 2014 Dec. (Health Technology Assessment, No. 18.69.) Appendix 6, Individual study results.
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