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Reply to “Methodologic lessons from published systematic reviews”

Eye volume 38, page 405 (2024)Cite this article

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We thank Ferriera et al. [1] for their interest in our recently published systematic review of optical coherence tomography angiography (OCT-A) studies in Parkinson’s disease. However, this letter is to clarify the methodological issues raised by the authors. Performing a meta-analysis on all included studies to calculate the overall pooled estimate and performing meta-regression and subgroup analysis on the overall estimates are methodologically accepted. This method is widely used in the meta-analysis studies and even in the meta-analysis of optical coherence tomography (OCT) studies. Nevertheless, this method is highly discouraged in the meta-analysis of OCT-A studies [2]. It has been shown that due to the differences in the boundaries used for the segmentation of the retinal layers between the OCT-A devices [3, 4], the results of studies using different machines are not comparable. Spaide and Curcio [3] evaluated the segmentation accuracy of retinal layers in three different OCT-A instruments (Cirrus 5000, RTVue XR Avanti, and Triton DRI) using a simultaneous histologic, and OCT-A evaluation of an autopsied eye. The authors demonstrated that all these instruments, segmented the retina at slightly different locations and the level of segmentation slabs varied widely between the instruments. In addition, given the fact that the instrument manufacturers have not stated whether the boundary is set at the top, middle, or the bottom of a certain layer, they found it difficult to cross-correlate the segmentation lines. In line with these, Lu and colleagues compared the microvasculature metrics of seventeen patients with chorioretinal diseases between three OCT-A devices (Optovue Avanti Angiovue, Topcon DRI-OCT Triton Swept-Source OCT, and Zeiss Cirrus 5000-HD-OCT Angioplex) and showed that the devices reported significantly different measurements for retinal layers, except for the foveal avascular zone (FAZ) [5]. Therefore, we highly recommend future systematic reviews and meta-analyses of OCT-A studies to pool the data on different machines separately, except for the measurements of FAZ, which have been shown to be comparable between various OCT-A devices.

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Data availability

The datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request.

References

  1. Ferreira A, Vieira RJ, Sousa-Pinto B Methodologic lessons from published systematic reviews. Eye. 2023. Online ahead of print.

  2. Rifai OM, McGrory S, Robbins CB, Grewal DS, Liu A, Fekrat S, et al. The application of optical coherence tomography angiography in Alzheimer’s disease: A systematic review. Alzheimers Dement. 2021;13:e12149. https://doi.org/10.1002/dad2.12149

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Author notes

  1. The authors contributed equally: Soheil Mohammadi, Fateme Rezagholi, Mohammad Amin Salehi.

Authors and Affiliations

  1. School of Medicine, Tehran University of Medical Sciences, Tehran, Iran

    Soheil Mohammadi, Mohammad Amin Salehi & Mahdi Gouravani

  2. School of Medicine, Qazvin University of Medical Sciences, Qazvin, Iran

    Fateme Rezagholi

  3. School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran

    Seyed Sina Zakavi

  4. School of Medicine, Guilan University of Medical Sciences, Rasht, Iran

    Ali Jahanshahi

  5. Department of Ophthalmology and Visual Sciences, Illinois Eye and Ear Infirmary, University of Illinois at Chicago, Chicago, IL, USA

    Ghasem Yazdanpanah

  6. Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA

    Sayena Jabbehdari

  7. Center for Ophthalmic Bioinformatics, Cole Eye Institute, Cleveland Clinic, Cleveland, OH, USA

    Rishi P. Singh

Authors
  1. Soheil Mohammadi
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Contributions

Author contributions included conception and study design (SM and MAS), article screening (AJ and MAS and SM), data collection or acquisition (SSZ, MAS, and SM), statistical analysis (MAS and SM), interpretation of results (MAS and SM and FR), drafting the manuscript work or revising it critically for important intellectual content (MAS, SM, FR, MG, GY, SJ, and RS) and approval of the final version to be published and agreement to be accountable for the integrity and accuracy of all aspects of the work (MAS, SM, FR, MG, GY, SJ, and RS).

Corresponding author

Correspondence to Rishi P. Singh.

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Authors declare no conflicts of interest except RS who is a consultant for Genentech, Regeneron, Alcon, Bausch and Lomb, Asclepix, Gyroscope, Novartis.

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Mohammadi, S., Rezagholi, F., Salehi, M.A. et al. Reply to “Methodologic lessons from published systematic reviews”. Eye 38, 405 (2024). https://doi.org/10.1038/s41433-023-02692-9

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