Vernon S A, Jones S J, Henry D J
Academic Unit of Ophthalmology, University of Nottingham.
Eye (Lond). 1991;5 ( Pt 4):491-3. doi: 10.1038/eye.1991.80.
Data from a glaucoma screening study involving 88.5% of the population age 50 and over of a single handed general practitioner were reanalysed to determine the effect of altering the protocol for intraocular pressure assessment and the effect of changing the referral threshold. The predictive power of the Keeler Pulsair noncontact tonometer was found to decrease from 22.5% at four pulses per eye to 12.3% when only one pulse per eye was used, with a reduction of sensitivity from 91.7% to 75%. The sensitivity of the same device fell from 91.7% if all patients with an IOP greater than 21 mmHg were deemed as having a positive screen, to 41.6% when only patients with an IOP greater than 26 mmHg were considered for referral. To create a balance between high sensitivity and acceptable predictive power of a positive result in a population where 50% of glaucoma sufferers are known prior to screening, we advise that four pulses per eye should be used with an IOP of greater than 22 mmHg used as the significant finding indicating that the patient required referral.
对一项青光眼筛查研究的数据进行了重新分析，该研究涵盖了一位全科医生接诊的50岁及以上人群的88.5%，以确定改变眼压评估方案的效果以及改变转诊阈值的影响。结果发现，Keeler Pulsair非接触眼压计的预测能力从每只眼睛测量4次脉搏时的22.5%降至每只眼睛仅测量1次脉搏时的12.3%，灵敏度从91.7%降至75%。如果将所有眼压高于21 mmHg的患者视为筛查阳性，则同一设备的灵敏度从91.7%降至仅考虑将眼压高于26 mmHg的患者转诊时的41.6%。为了在已知50%的青光眼患者在筛查前已确诊的人群中，在高灵敏度和阳性结果可接受的预测能力之间取得平衡，我们建议每只眼睛测量4次脉搏，并将眼压高于22 mmHg作为表明患者需要转诊的显著发现。
