Performance of a Glaucoma Screening Program Compared With Opportunistic Detection in China. Issue 2 (9th February 2023)

• Record Type: Journal Article
• Authors: Xie, Yanqian; Jiang, Junhong; Liu, Chi; Lin, Haishuang; Wang, Lin; Zhang, Cong; Chen, Jinyuan; Liang, Yuanbo; Congdon, Nathan; Zhang, Shaodan
• Is Part Of: Journal of glaucoma. Volume 32:Issue 2(2023)
• Page Start: 80
• Page End: 84
• Publication Date: 2023-02-09
• Subjects: glaucoma -- opportunistic screening -- health examination center -- visual impairment; Glaucoma -- Periodicals; 617.741005
• DOI: 10.1097/IJG.0000000000002125
• Languages: English
• ISSNs: 1057-0829

Abstract

Abstract : Précis: Health examination center-based screening provide a good supplement to clinic-based glaucoma care by detecting early-stage glaucoma, especially those with normal intraocular pressure (IOP) and less visual impairment. Purpose: Opportunistic glaucoma screening for early case identification is of great value in the prevention of severe visual impairment, however, novel, low-cost models are needed. We aimed to determine whether health examination center-based glaucoma screening identifies diseases earlier than outpatient cases in China. Materials and Methods: In this case-control study, 76 patients with primary glaucoma identified from a health examination center-based glaucoma screening program and 272 consecutive outpatient cases at the same hospital were enrolled from March 21 to September 30, 2016. Demographic characteristics, best-corrected visual acuity, IOP, mean deviation (MD), and pattern standard deviation (PSD) on Humphrey visual field testing in the better-seeing eye were compared between groups. Results: Screening-detected glaucoma patients had significantly lower IOP (18.3±4.2 mm Hg) than out-patient cases (26.7±12.6 mm Hg, P <0.001). Most (71.1%) of the screening-detected patients had IOP<21 mm Hg compared with 37.1% in the clinic group ( P <0.001). Seventy-five patients (98.7%) in the screening group were diagnosed as primary open angle glaucoma, compared with 44.1% in the clinic group ( P <0.001). Screening-detected patients had significantly less visual impairment than the clinic group (6.6% vs. 38.6%, P <0.05). Mean MD (−4.4±5.0 dB) and PSD (4.4±3.6 dB) for the screening group were superior to the clinic group (MD: −16.5±10.5 dB, P <0.001; PSD: 6.5±3.7 dB, P <0.001). Conclusion: The glaucoma screening program was effective at detecting early disease, especially normal tension glaucoma and supplemented opportunistic detection of glaucoma.