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Abstract #46607 Published in IGR 13-3
Population and high-risk group screening for glaucoma: The Los Angeles Latino eye study
Francis BA; Varma R; Vigen C; Lai M-Y; Winarko J; Nguyen B; Azen SInvestigative Ophthalmology and Visual Science 2011; 52: 6257-6264
PURPOSE. To evaluate the ability of various screening tests, both individually and in combination, to detect glaucoma in the general Latino population and high-risk subgroups. METHODS. The Los Angeles Latino Eye Study is a populationbased study of eye disease in Latinos 40 years of age and older. Participants (n = 6082) underwent Humphrey visual field testing (HVF), frequency doubling technology (FDT) perimetry, measurement of intraocular pressure (IOP) and central corneal thickness (CCT), and independent assessment of optic nerve vertical cup disc (C/D) ratio. Screening parameters were evaluated for three definitions of glaucoma based on optic disc, visual field, and a combination of both. Analyses were also conducted for high-risk subgroups (family history of glaucoma, diabetes mellitus, and age (greater-than or equal to)65 years). Sensitivity, specificity, and receiver operating characteristic curves were calculated for those continuous parameters independently associated with glaucoma. Classification and regression tree (CART) analysis was used to develop a multivariate algorithm for glaucoma screening. RESULTS. Preset cutoffs for screening parameters yielded a generally poor balance of sensitivity and specificity (sensitivity/ specificity for IOP (greater-than or equal to)21 mm Hg and C/D (greater-than or equal to)0.8 was 0.24/0.97 and 0.60/0.98, respectively). Assessment of high-risk subgroups did not improve the sensitivity/specificity of individual screening parameters. A CART analysis using multiple screening parameters-C/D, HVF, and IOP-substantially improved the balance of sensitivity and specificity (sensitivity/specificity 0.92/0.92). CONCLUSIONS. No single screening parameter is useful for glaucoma screening. However, a combination of vertical C/D ratio, HVF, and IOP provides the best balance of sensitivity/specificity and is likely to provide the highest yield in glaucoma screening programs.
R. Varma. Doheny Eye Institute and the Department of Ophthalmology, Keck School of Medicine, University of Southern California, Suite 4803, 1450 San Pablo Street, Los Angeles, CA 90033, United States.
Classification:
1.6 Prevention and screening (Part of: 1 General aspects)
