September 2016
Volume 57, Issue 12
Open Access
ARVO Annual Meeting Abstract  |   September 2016
Optimizing approaches to identify glaucoma among at-risk population: the SToP Glaucoma study
Author Affiliations & Notes
  • David S Friedman
    Dana Center for Preventive Ophthalmology, Johns Hopkins Wilmer Eye Inst, Baltimore, Maryland, United States
    Epidemiology and International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States
  • Di Zhao
    Dana Center for Preventive Ophthalmology, Johns Hopkins Wilmer Eye Inst, Baltimore, Maryland, United States
    Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States
  • Lucy I Mudie
    Dana Center for Preventive Ophthalmology, Johns Hopkins Wilmer Eye Inst, Baltimore, Maryland, United States
  • Bonnielin K Swenor
    Dana Center for Preventive Ophthalmology, Johns Hopkins Wilmer Eye Inst, Baltimore, Maryland, United States
    Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States
  • Eliseo Guallar
    Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States
  • Footnotes
    Commercial Relationships   David Friedman, Allergan (R), ForSight V (C), Nidek (C); Di Zhao, None; Lucy Mudie, None; Bonnielin Swenor, None; Eliseo Guallar, None
  • Footnotes
    Support  CDC Grant U58 DP002653
Investigative Ophthalmology & Visual Science September 2016, Vol.57, 1558. doi:
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    • Get Citation

      David S Friedman, Di Zhao, Lucy I Mudie, Bonnielin K Swenor, Eliseo Guallar; Optimizing approaches to identify glaucoma among at-risk population: the SToP Glaucoma study. Invest. Ophthalmol. Vis. Sci. 2016;57(12):1558.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To develop, implement and evaluate replicable community-based interventions designed to improve eye disease detection and follow-up care in high-risk populations.

Methods : This is an ongoing study of a screening program using trained personnel to identify individuals with vision needs in inner-city communities, focusing on African Americans and Hispanics at multiple community sites in Baltimore, MD. The screening examination includes presenting visual acuity (VA), best-corrected VA (for those with VA worse than 20/40) using autorefraction, digital fundus imaging, visual field, and intraocular pressure using a sequential referral approach (Figure 1). Field personnel determine referral status, and a glaucoma specialist reviews all fundus images to confirm appropriate referral. Participants are classified into 3 categories: no referral, referral for possible eye disease, or referral for refraction only. Those referred were seen at no cost for a definitive exam at the Wilmer Eye Institute.

Results : 901 individuals were screened and were mostly African Americans (94.9%) with a mean (SD) age of 64.3 (9.9) and BMI of 30.6 (7.7) (Table 1). 356 (39.5%) and 107 (11.9%) participants were referred for a definitive eye exam and refraction, respectively. 47 (7.2%) individuals had cup:disc ratio ≥ 0.7, 38 (5.8%) had macula abnormalities, 56 (6.4%) had an IOP ≥ 23 mmHg and 172 (19.1%) needed glasses. The most common reason for referral was refraction without other ocular issues (23.1%), followed by ungradable fundus image (22.3%), BCVA < 20/40 (11.2%) and ungradable autorefraction (9.1%) (Figure 2). Referred participants were older and less well educated (p < 0.05).

Conclusions : A large proportion of individuals 50 years of age and older screened for eye problems require ophthalmic services, particularly those who are older and less well educated. Programs will have to focus on encouraging these individuals to attend screening exams as they are more likely to have treatable conditions.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.

 

Flow of screening in the SToP Glaucoma Study

Flow of screening in the SToP Glaucoma Study

 

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