Niessen A G, Langerhorst C T, Geijssen H C, Greve E L
Glaucoma Center, Department of Ophthalmology, University of Amsterdam, The Netherlands.
Doc Ophthalmol. 1997;93(4):293-315. doi: 10.1007/BF02569068.
In 1991 the Netherlands Glaucoma Patient Association organized a glaucoma screening survey. This survey was designed to evaluate the effectiveness of a low cost screening setting. During a screening period of 8 days, 1259 subjects over the age of 49 years were examined by a team of non-ophthalmologically trained students. The following screening methods were used: visual field analysis (Henson CFS3000 perimeter), retinal nerve fiber layer photography (Canon non-mydriatic camera), intraocular pressure measurement (Pulsair non-contact tonometer) and determination of the peripheral anterior chamber depth (slitlamp biomicroscope, the van Herick method). In a later stage, subjects with glaucomatous abnormalities in the visual field and/or the photograph were re-examined by a glaucoma specialist using applanation tonometry, gonioscopy, ophthalmoscopy and Humphrey 30-2 visual field analysis. The time taken to conduct the individual screening tests in a subject varied from 1 to 5 min: perimetry took 5 min, photography 2 min, tonometry 3 min and angle-width determination 1 min. Fifty-six (4.4%) subjects showed glaucomatous defects in perimetry and/or photography. Thirty-seven could be re-examined and glaucoma was diagnosed in 16 subjects. Visual field defects and glaucomatous abnormalities in the photograph were confirmed by Humphrey perimetry in 72.7% and 35.7% respectively. Sixty-seven (5.3%) subjects had an intraocular pressure above 21 mm Hg, while no cases of angle closure glaucoma were found in this population. The costs of this screening setting were estimated at F1. 48,60 per screen. A future low cost screening survey might be limited to non-contact tonometry and visual field analysis with the Henson CFS3000 perimeter or a similar device, using suprathreshold testing with a limited number of points. Screening might be performed by non-medically trained employees. The costs of such a screening program may be estimated at F1. 16,- per screen and F1. 1.989,- per glaucoma case using a mobile screening unit (addendum).
1991年，荷兰青光眼患者协会组织了一次青光眼筛查调查。该调查旨在评估低成本筛查方案的有效性。在为期8天的筛查期间，一组未经眼科专业培训的学生对1259名49岁以上的受试者进行了检查。采用了以下筛查方法：视野分析（Henson CFS3000视野计）、视网膜神经纤维层摄影（佳能免散瞳相机）、眼压测量（Pulsair非接触眼压计）以及周边前房深度测定（裂隙灯显微镜，范·赫里克法）。在后期，视野和/或照片显示有青光眼异常的受试者由青光眼专家使用压平眼压计、前房角镜检查、检眼镜检查和Humphrey 30-2视野分析进行复查。对一名受试者进行各项筛查测试所需的时间从1分钟到5分钟不等：视野检查需要5分钟，摄影需要2分钟，眼压测量需要3分钟，房角宽度测定需要1分钟。56名（4.4%）受试者在视野检查和/或摄影中显示有青光眼性缺损。37名受试者得以复查，其中16名被诊断为青光眼。视野缺损和照片中的青光眼性异常分别经Humphrey视野检查确诊的比例为72.7%和35.7%。67名（5.3%）受试者眼压高于21 mmHg，而该人群中未发现闭角型青光眼病例。此次筛查方案的成本估计为每次筛查48.60荷兰盾。未来的低成本筛查调查可能仅限于非接触眼压测量以及使用Henson CFS3000视野计或类似设备进行视野分析，采用有限点数的超阈值测试。筛查可由未经医学培训的工作人员进行。这样一个筛查项目的成本估计为每次筛查16荷兰盾，使用移动筛查设备时每例青光眼病例的成本为1989荷兰盾（附录）。
