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S. Ohkubo, H. Takeda, T. Higashide, T. Sasaki, K. Sugiyama; A Pilot Study to Detect Glaucoma with Confocal Scanning Laser Ophthalmoscopy Compared to Nonmydriatic Stereoscopic Photography in a Community Health Screening. Invest. Ophthalmol. Vis. Sci. 2007;48(13):3310.
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To assess the efficacy and practical usefulness of the Heidelberg Retina Tomograph II (HRT II) compared with nonmydriatic stereoscopic photography in a public glaucoma screening.
We examined 1,173 local residents, aged 40 years or older, who visited a community health screening in Komatsu City. Initial glaucoma screening consisted of non-contact pneumotonometry, nonmydriatic stereoscopic fundus photography and HRT II. When glaucoma was suspected, the subjects were referred for a definitive examination, in which slit-lamp biomicroscopic examination, Goldmann applanation tonometry, Humphrey 30-2 test, gonioscopy, and optic nerve head evaluation were performed.
A total of 97.2% (2279/2345) of the nonmydriatic stereoscopic optic disc photographs could be interpreted and 93.4% (2189/2345) were good images. HRT II measurements were successful in 99.0% (2322/2345) of eyes, and acceptable images were obtained in 91.9% (2154/2345) of eyes. Based on clinical diagnoses, 94 eyes of 60 participants were diagnosed with glaucoma. The sensitivity of nonmydriatic stereoscopic photographs for personal-level analysis and eye-level analysis were 95.8% (with a specificity of 93.8%) and 95.5% (with a specificity of 95.5%), respectively. Using Moorfields regression analysis, HRT sensitivity and specificity were 72.3% to 91.5% and 84.0% to 93.1%, respectively, for personal analysis, and 60.3% to 72.6% and 89.7% to 95.6%, respectively, for eye-level analysis.
Although HRT II diagnosis is not definitive until confirmed by a glaucoma specialist’s clinical fundus examination or evaluation of stereophotographs, HRT II is a useful tool for glaucoma mass screening.
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