Laroche Daniel, Rickford Kara, Mike Elise V, Hunter Liane, Ede Ezekiel, Ng Chester, Douglas John
New York Eye and Ear Infirmary, Icahn School of Medicine of Mount Sinai, New York, NY, USA.
Advanced Eye Care of New York, New York, NY, USA.
J Ophthalmol. 2022 Jul 31;2022:5288726. doi: 10.1155/2022/5288726. eCollection 2022.
Glaucoma is a leading cause of preventable blindness globally. Nearly, half of the patients who have glaucoma in the United States are unaware of their diagnosis, and this number is far greater in resource poor areas. The risk of progressive and irreversible loss of vision is decreased with an early diagnosis, and better access to treatment is vital to improve the visual outcome for patients. We therefore postulated that a minimally invasive, low-cost calculator used to predict the risk of glaucoma and inform the course of follow-up care will improve patient prognosis. We retrospectively examined data from 104 eyes of patients who underwent a complete ocular examination, visual field, and corneal pachymetry at Advanced Eye Care of New York (54 with glaucoma and 50 controls). Receiver operating curves (ROC) were utilized to determine the correct glaucoma classification rates of the Laroche glaucoma calculator (Range -3 to 18), a novel tool that combines age, intraocular pressure (IOP), and central corneal thickness (CCT) into a composite metric. Additionally, we compared the discriminatory power of this calculator to age, intraocular pressure (IOP), and central corneal thickness (CCT) separately. A score of greater than or equal to 6 on the Laroche glaucoma calculator (sensitivity 90.74%, specificity 64.00%, correct classification 77.88%) optimizes the accuracy of this tool. Compared to IOP (Area Under the Curve (AUC) = 0.72, chi = 4.21, =0.04) and CCT (AUC = 0.53), chi 24.72 < 0.001), the Laroche glaucoma calculator (AUC = 0.81) was significantly better at discriminating against glaucoma patients vs. controls. These results demonstrate that the Laroche calculator is a novel, effective tool for identifying glaucoma, and it may provide a low-cost risk stratification tool, particularly in areas with limited resources.
青光眼是全球可预防失明的主要原因。在美国，近一半的青光眼患者不知道自己已被诊断出患有该病，而在资源匮乏地区，这一数字要高得多。早期诊断可降低视力进行性和不可逆丧失的风险，更好地获得治疗对于改善患者的视力预后至关重要。因此，我们推测，一种用于预测青光眼风险并指导后续护理过程的微创低成本计算器将改善患者预后。我们回顾性分析了在纽约高级眼科护理中心接受全面眼部检查、视野检查和角膜测厚的104只眼睛的患者数据（54例青光眼患者和50例对照）。利用受试者工作特征曲线（ROC）来确定拉罗什青光眼计算器（范围-3至18）对青光眼的正确分类率，这是一种将年龄、眼压（IOP）和中央角膜厚度（CCT）组合成一个综合指标的新型工具。此外，我们分别比较了该计算器与年龄、眼压（IOP）和中央角膜厚度（CCT）的鉴别能力。拉罗什青光眼计算器得分大于或等于6（灵敏度90.74%，特异性64.00%，正确分类77.88%）可优化该工具的准确性。与眼压（曲线下面积（AUC）=0.72，卡方=4.21，P=0.04）和中央角膜厚度（AUC=0.53，卡方=24.72，P<0.001）相比，拉罗什青光眼计算器（AUC=0.81）在区分青光眼患者与对照方面明显更好。这些结果表明，拉罗什计算器是一种用于识别青光眼的新型有效工具，它可能提供一种低成本的风险分层工具，特别是在资源有限的地区。
