Optical Coherence Tomography Angiography Changes in Patients Diagnosed With Acute Coronary Syndrome: A Systematic Review and Meta-Analysis

Abstract

We conducted a systematic review and meta-analysis to assess the association between optical coherence tomography angiography (OCTA) parameters and acute coronary syndrome (ACS). Two independent reviewers searched the electronic databases (MEDLINE (Medical Literature Analysis and Retrieval System Online), Scopus, Embase (Excerpta Medica Database), Cochrane Library, ClinicalTrials.gov, and World Health Organization International Clinical Trials Registry Platform) from inception until April 2023. According to the inclusion criteria of this review, eligible were observational studies, randomized control trials, and registry/database studies that included the eyes of adult ACS patients and assessed OCTA parameters within the macula. The pooled standardized mean differences (SMD) between patients diagnosed with ACS and healthy controls with a confidence interval (CI) of 95% were calculated using the Hartung-Knapp-Sidik-Jonkman random-effects method. The heterogeneity was assessed by I² and the Cochran Q and a random effects model was applied. Seven studies were eligible and included in our systematic review (n = 898), of which three were included in the meta-analysis (n = 341). The pooled SMD in the superficial vascular plexus (SVP), deep vascular plexus (DVP), and foveal avascular zone (FAZ) were -0.46 (95% CI: -0.94 to 0.01, p = 0.05, I² = 0%, three studies), -0.10 (95% CI: -3.20 to 3.00, p = 0.75, I² = 67%, two studies), and 0.43 (95% CI: -1.22 to 2.09, p = 0.38, I² = 92%, three studies), respectively. Our findings suggest that there are no differences in OCTA metrics between ACS patients and healthy individuals.

Keywords: acs (acute coronary syndrome); deep vascular plexus; foveal avascular zone; optical coherence tomography angiography (oct-a); st-segment elevation myocardial infarction (stemi); superficial vascular plexus.

Figure 1. PRISMA flow diagram of the study selection process

PRISMA: Preferred Reporting Items for Systematic Reviews and Meta-Analyses; ICTRP: International Clinical Trials Registry Platform EndNote (Clarivate PLC, London, United Kingdom)

Figure 2. Forest plots of the SMDs on patients with ACS and healthy participants

ACS: acute coronary syndrome; CI: confidence interval; SMDs: standardized mean differences [11,24,25]