Cluster-randomised trial of community-based screening for eye disease in adults in Nepal: the Village-Integrated Eye Worker Trial II (VIEW II) trial protocol. Issue 10 (15th October 2020)

• Record Type: Journal Article
• Authors: O'Brien, Kieran S; Stevens, Valerie M; Byanju, Raghunandan; Kandel, Ram Prasad; Bhandari, Gopal; Bhandari, Sadhan; Melo, Jason S; Porco, Travis C; Lietman, Thomas M; Keenan, Jeremy D
• Other Names: author non-byline.; Acharaya Prakriti author non-byline.; Adhikari Manmohan author non-byline.; Adihikari Shree Kanta author non-byline.; Bhattarai Deepak author non-byline.; Bhattarai Rabin author non-byline.; Bhandari Gopal author non-byline.; Bhandari Sadhan author non-byline.; Byanju Raghunandan author non-byline.; Chaudhary Ajaya author non-byline.; Chaudhary Bhagiram author non-byline.; Chaudhary Daya Shankar author non-byline.; Chaudhary Kishor author non-byline.; Dharel Krishna Raj author non-byline.; Gautam Maria author non-byline.; Gautam Shree Krishna author non-byline.; Ghimire Aakriti author non-byline.; Ghimire Bishwash author non-byline.; Ghimire Narayan author non-byline.; Ghimire Ramesh author non-byline.; Giri Gaurav author non-byline.; Giri Puspa author non-byline.; Gurau Dhanmaya author non-byline.; Gurung Ramesh author non-byline.; Kandel Deepak author non-byline.; Khadka Simanta author non-byline.; Lamichhane Benju author non-byline.; Mahato Pappu author non-byline.; Neupane Pratikshya author non-byline.; Panday Ram Janaki author non-byline.; Parajuli Sabina author non-byline.; Poudel Radhika Devi author non-byline.; Poudel Susmita author non-byline.; Pradhan Sangita author non-byline.; Pun Suchan author non-byline.; Ranabhat Bishaka author non-byline.; Ranabhat Sudha author non-byline.; Rimal Gaurav author non-byline.; Sapkota Gopal author non-byline.; Sapkota Subit author non-byline.; Shah Ranjeet author non-byline.; Shrestha Manisha author non-byline.; Silwal Saraswati author non-byline.; Subedi Amisha author non-byline.; Subedi Pradeep author non-byline.; Tamang Alish author non-byline.; Tandukar Dilip author non-byline.; Wagle Nischal Sharma author non-byline.; Yadav Nilam Kumari author non-byline.; Mishra Sailesh author non-byline.; Chase Heidi author non-byline.; Gilbert Suzanne author non-byline.; Jesudason Lauren author non-byline.; Tenzing Chundak author non-byline.; Chaudhary Shravan author non-byline.; Dhakwha Parami author non-byline.; Kandel Ram Prasad author non-byline.; Sharma Prasanna author non-byline.; Shrestha Apsara author non-byline.; Keenan Jeremy author non-byline.; Lietman Thomas author non-byline.; Melo Jason author non-byline.; O'Brien Kieran author non-byline.; Porco Travis author non-byline.; Schwartz Daniel author non-byline.; Shrestha Riju author non-byline.; Stamper Robert author non-byline.; Stevens Valerie author non-byline.;
• Is Part Of: BMJ open. Volume 10:Issue 10(2020)
• Publication Date: 2020-10-15
• Subjects: mass screening -- glaucoma -- diabetic retinopathy -- age-related macular degeneration -- randomised controlled trial; Medicine -- Research -- Periodicals; 610.72
• DOI: 10.1136/bmjopen-2020-040219
• Languages: English
• ISSNs: 2044-6055

Abstract

Abstract : Introduction: The majority of blindness worldwide could be prevented or reversed with early diagnosis and treatment, yet identifying at-risk and prevalent cases of eye disease and linking them with care remain important obstacles to addressing this burden. Leading causes of blindness like glaucoma, diabetic retinopathy and age-related macular degeneration have detectable early asymptomatic phases and can cause irreversible vision loss. Mass screening for such diseases could reduce visual impairment at the population level. Methods and analysis: This protocol describes a parallel-group cluster-randomised trial designed to determine whether community-based screening for glaucoma, diabetic retinopathy and age-related macular degeneration reduces population-level visual impairment in Nepal. A door-to-door population census is conducted in all study communities. All adults aged ≥60 years have visual acuity tested at the census visit, and those meeting referral criteria are referred to a local eye care facility for further diagnosis and management. Communities are subsequently randomised to a community-based screening programme or to no additional intervention. The intervention consists of a single round of screening including intraocular pressure and optical coherence tomography assessment of all adults ≥60 years old with enhanced linkage to care for participants meeting referral criteria. Four years after implementation of the intervention, masked outcome assessors conduct a repeat census to collect data on the primary outcome, visual acuity. Individuals with incident visual impairment receive a comprehensive ophthalmological examination to determine the cause of visual impairment. Outcomes are compared by treatment arm according to the originally assigned intervention. Ethics and dissemination: The trial has received ethical approval from the University of California San Francisco Institutional Review Board, Nepal Netra Jyoti Sangh and the Nepal Health Research Council. Results of this trial will be disseminated through publication in peer-reviewed journals and presentation at local and international meetings. Trial registration number: NCT03752840