[A pilot study on rapid glaucoma screening]

Abstract

Objective: To screen glaucoma effectively and rapidly and evaluate the specificity and sensitivity of the method.

Methods: 734 subjects were screened in 4 weekend days. All subjects underwent intraocular pressure (IOP) examination with Tonopen, anterior chamber depth measurement with Van Herick method, fundus photography without pupil dilatation and supra-threshold perimetry with Frequency Doubling Perimeter (FDP), Octopus and Humphery automatic perimeter. The cases with positive results in the above examinations should undertake threshold perimetry and fundus stereo photography for the evaluation of the retinal nerve fiber layer (RNFL).

Results: Of the 734 subjects with complete data, there were 55 cases with open angle glaucoma (7.5%), 59 angle-closure glaucoma (8.4%) and 98 glaucoma suspects (13.4%). The IOP of 34 patients was > 21 mm Hg in all the glaucomatous patients (29.8%). The abnormal rates of optic nerve and visual field were 94.5% and 67.3% respectively in the patients with open-angle glaucoma. The abnormal rates of anterior chamber, visual field and optic nerve were 89.8%, 72.9% and 45.8% respectively.

Conclusions: The most efficient method for screening open-angle glaucoma is fundus stereo photography with evaluation by an expert. Anterior chamber evaluation is necessary in screening glaucoma. Supra-threshold perimetry has limited specificity, and FDP might be a promising method in screening glaucoma with relatively good specificity.