title: Confocal scan laser ophthalmoscope for diagnosing glaucoma: a systematic review and meta-analysis.
abstract: This systematic review was performed to estimate the diagnostic accuracy of the confocal scanning laser ophthalmoscopy in diagnosing glaucoma. We did a sensitive electronic search to find relevant studies. Two reviewers independently screened relevant articles and extracted required data about study methods and reported results of sensitivity and specificity. A meta-analysis was conducted for pooling data to compare different editions of the Heidelberg Retina Tomograph (HRT) with one of its alternatives, scanning laser polarimetry (GDx) with the criteria of "visual field defect" and "changes of nerve fiber layer" as the reference standard. We identified 37 evaluations from 28 relevant primary studies. In these studies, 9573 eyes (4883 glaucomatous and 4689 non-glaucomatous) were assessed with regards to the reference standard using one of the HRT editions with or without GDx. Diagnostic odds ratios were 9.35 [95% confidence interval (CI): 7.58-11.53] for HRT, 11.84 (95% CI: 9.97-14.06) for HRT II, 11.86 (95% CI: 9.16-15.35) for HRT III, and 21.33 (95% CI, 13.56-33.55) for GDx. Although GDx was more accurate than HRT, all editions of HRT had acceptable performance in diagnosing glaucomatous eyes with an ophthalmologist's clinical examination as the reference standard.
authors.affiliation: From the *Clinical Knowledge Management Unit, Department of Community Medicine, School of Medicine, Iran University of Medical Sciences, Tehran; †Iran University of Medical Science, Tehran, Iran; ‡Glaucoma Service, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran; and §Cochrane Schizophrenia Group, the Institute of Mental Health, a partnership between the University of Nottingham and Nottinghamshire Healthcare NHS Trust, Nottingham, UK.
authors.forename: Mohsen
authors.initials: M
authors.lastname: Yaghoubi
authors.forename: Maziar
authors.initials: M
authors.lastname: Moradi-Lakeh
authors.forename: Mehdi
authors.initials: M
authors.lastname: Mokhtari-Payam
authors.forename: Ghasem
authors.initials: G
authors.lastname: Fakhraie
authors.forename: Farhad
authors.initials: F
authors.lastname: Shokraneh
mesh_terms: D003941:Diagnostic Techniques, Ophthalmological; D005901:Glaucoma / Q000175:diagnosis*; D006801:Humans; D018613:Microscopy, Confocal / Q000379:methods*; D009887:Ophthalmoscopy / Q000379:methods*; D057109:Scanning Laser Polarimetry / Q000379:methods; D012680:Sensitivity and Specificity; D058609:Visual Field Tests / Q000379:methods; D014794:Visual Fields