The Eye Hospital, School of Ophthalmology & Optometry, Wenzhou Medical University, Glaucoma Research Institute of Wenzhou Medical University, Zhejiang, China.
Department of Ophthalmology, the Fourth Peoples' Hospital of Shenyang, Shenyang Key Lab of Ophthalmology, Liaoning, China.
Clin Exp Ophthalmol. 2019 Nov;47(8):1000-1008. doi: 10.1111/ceo.13564. Epub 2019 Jun 20.
Under-detection and late diagnosis are major causes of glaucoma-related visual impairment. Cost-effective opportunistic glaucoma screening is of great interest in the early identification and prevention of glaucoma.
To describe the results of a health examination centre-based opportunistic glaucoma screening and referral model.
This single centre cross-sectional study was conducted in a health examination centre affiliated to a tertiary hospital in Shenyang, northeastern China.
From 21 March to 30 September 2016, 14 367 individuals aged ≥ 30 years undergoing routine physical examinations were invited for this glaucoma screening.
Presenting visual acuity, non-contact pneumotonometry and non-mydriatic fundus photography were evaluated. Fundus photographs were classified as non-glaucoma, possible, probable and definitive glaucoma. Participants with probable and definite glaucomatous discs or intraocular pressure ≥ 24 mmHg were referred for definitive examinations.
Detection rate of glaucoma suspects and ocular hypertension (OHT). Cost to identify a single case with suspected and diagnosed glaucoma was also calculated.
Altogether, 277 glaucoma suspects and 327 ocular hypertension suspects were identified. Among 190 participants with probable/definite glaucomatous discs, 93 (48.9%) accepted further examination. Among these, 78 were diagnosed as glaucoma, seven as suspects and eight were excluded. Only 98 ocular hypertension suspects (30.0%) accepted further examinations: eight had primary angle closure and 23 had confirmed ocular hypertension. The cost to identify a single glaucoma suspect and definite glaucoma case were US$135 and US$857, respectively.
This novel screening model provides opportunities to improve glaucoma detection at low cost. Interventions to improve follow-up are needed.
青光眼相关视觉损伤的主要原因是漏诊和诊断延迟。具有成本效益的机会性青光眼筛查对于早期识别和预防青光眼具有重要意义。
描述一个以健康检查中心为基础的机会性青光眼筛查和转诊模式的结果。
本单中心横断面研究在中国东北部沈阳的一家三级医院附属的健康检查中心进行。
2016 年 3 月 21 日至 9 月 30 日，共有 14367 名年龄≥30 岁的个体接受了常规体检，受邀参加了此次青光眼筛查。
评估了眼前视力、非接触眼压计和非散瞳眼底照相。眼底照片分为非青光眼、可能、可能和明确青光眼。疑似和明确青光眼的可疑和确诊病例的眼压≥24mmHg 者，转诊进行明确检查。
青光眼和高眼压症（OHT）的检出率。还计算了识别一个疑似和确诊青光眼病例的成本。
共发现 277 名青光眼疑似患者和 327 名高眼压疑似患者。在 190 名疑似/确诊青光眼可疑患者中，93 名（48.9%）接受了进一步检查。其中 78 例诊断为青光眼，7 例为可疑病例，8 例被排除。只有 98 名高眼压疑似患者（30.0%）接受了进一步检查：8 例为原发性闭角型青光眼，23 例为确诊高眼压。识别一个青光眼疑似病例和确诊青光眼病例的成本分别为 135 美元和 857 美元。
这种新型筛查模式提供了以低成本提高青光眼检出率的机会。需要采取干预措施以改善随访。
