Vernon S A
Department of Ophthalmology, University Hospital, Queen's Medical Centre, Nottingham, UK.
Eye (Lond). 1998;12 ( Pt 5):854-7. doi: 10.1038/eye.1998.217.
To identify any change in optometric referral patterns for suspect glaucoma over a 5 year period.
A retrospective analysis was carried out of referrals for suspect glaucoma to a hospital glaucoma clinic from 1988 and 1993.
There was a significant decrease in the positive referral rate with time from 56% in 1988 to 37% in 1993 (p = 0.02). Intraocular pressures (IOPs) of all patients prior to referral and at presentation to the glaucoma clinic were significantly higher in 1988 (25.1 and 25.6 mmHg respectively) than in 1993 (22.4 and 23.0 mmHg respectively, p < 0.0005). However, the presenting IOPs of eyes with glaucoma were similar in the cohorts (27.5 vs 26.4 mmHg, p = 0.33). Prior to referral, optometrists performed visual fields on 28% of patients in 1988 and on 48% in 1993 (p 0.01), giving an estimate of the cup/disc ratio in 15% of patients in 1988 and 41% in 1993 (p = 0.0004).
The increased false positive referral rate appears to be associated with the increasing use of visual field analysers by optometrists and a willingness to refer at lower IOPs. Increased false positive referrals result in increased waiting times for hospital assessment.
确定5年期间疑似青光眼验光转诊模式的任何变化。
对1988年至1993年转诊至一家医院青光眼诊所的疑似青光眼病例进行回顾性分析。
随着时间的推移，阳性转诊率显著下降，从1988年的56%降至1993年的37%（p = 0.02）。1988年所有患者转诊前和到青光眼诊所就诊时的眼压（IOP）显著高于1993年（分别为25.1和25.6 mmHg）（分别为22.4和23.0 mmHg，p < 0.0005）。然而，青光眼患者就诊时的眼压在两组中相似（27.5对26.4 mmHg，p = 0.33）。转诊前，验光师在1988年对28%的患者进行了视野检查，在1993年对48%的患者进行了视野检查（p 0.01），在1988年对15%的患者、在1993年对41%的患者进行了杯盘比评估（p = 0.0004）。
假阳性转诊率的增加似乎与验光师越来越多地使用视野分析仪以及在较低眼压时愿意转诊有关。假阳性转诊增加导致医院评估的等待时间增加。
