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Abstract #81183 Published in IGR 20-3
Integrating opportunistic glaucoma screening into general health examinations in China: A pilot study
Zhang S; Sun J; Liu S; Liang Y; Hu Y; Congdon N; Pang CP; Wang HClinical and Experimental Ophthalmology 2019; 47: 1000-1008
IMPORTANCE: 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. BACKGROUND: To describe the results of a health examination centre-based opportunistic glaucoma screening and referral model. DESIGN: This single centre cross-sectional study was conducted in a health examination centre affiliated to a tertiary hospital in Shenyang, northeastern China. PARTICIPANTS: From 21 March to 30 September 2016, 14 367 individuals aged ≥ 30 years undergoing routine physical examinations were invited for this glaucoma screening. METHODS: 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. MAIN OUTCOME MEASURES: Detection rate of glaucoma suspects and ocular hypertension (OHT). Cost to identify a single case with suspected and diagnosed glaucoma was also calculated. RESULTS: 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. CONCLUSIONS AND RELEVANCE: This novel screening model provides opportunities to improve glaucoma detection at low cost. Interventions to improve follow-up are needed.
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Classification:
1.6 Prevention and screening (Part of: 1 General aspects)
