June 2017
Volume 58, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2017
Anterior Segment Digital Photography Accuracy in the Evaluation of Pterygium: The Brazilian Amazon Region Eye Survey (BARES)
Author Affiliations & Notes
  • Adriana Berezovsky
    Departamento de Oftalmologia e Ciências Visuais, Universidade Federal de Sao Paulo, Sao Paulo, SP, Brazil
  • Marcia Higashi
    Departamento de Oftalmologia e Ciências Visuais, Universidade Federal de Sao Paulo, Sao Paulo, SP, Brazil
  • Arthur Gustavo Fernandes
    Departamento de Oftalmologia e Ciências Visuais, Universidade Federal de Sao Paulo, Sao Paulo, SP, Brazil
  • Paulo Henrique Morales
    Departamento de Oftalmologia e Ciências Visuais, Universidade Federal de Sao Paulo, Sao Paulo, SP, Brazil
  • Joao M Furtado
    Depto de Oftalmologia, Otorrinolaringologia e Cirurgia de Cabeca e Pescoco, Faculdade de Medicina de Ribeirao Preto, USP, Ribeirão Preto, Brazil
    Departamento de Oftalmologia e Ciências Visuais, Universidade Federal de Sao Paulo, Sao Paulo, SP, Brazil
  • Sung Watanabe
    Departamento de Oftalmologia e Ciências Visuais, Universidade Federal de Sao Paulo, Sao Paulo, SP, Brazil
  • Galton Carvalho Vasconcelos
    Departamento de Oftalmologia, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
    Departamento de Oftalmologia e Ciências Visuais, Universidade Federal de Sao Paulo, Sao Paulo, SP, Brazil
  • Marcos Jacob Cohen
    Divisao de Oftalmologia do Departamento de Cirurgia, Faculdade de Medicina da Universidade Federal do Amazonas, Manaus, AM, Brazil
    Departamento de Oftalmologia e Ciências Visuais, Universidade Federal de Sao Paulo, Sao Paulo, SP, Brazil
  • Jacob Moyses Cohen
    Divisao de Oftalmologia do Departamento de Cirurgia, Faculdade de Medicina da Universidade Federal do Amazonas, Manaus, AM, Brazil
    Instituto de Olhos de Manaus, Manaus, AM, Brazil
  • Marcela Cypel
    Departamento de Oftalmologia e Ciências Visuais, Universidade Federal de Sao Paulo, Sao Paulo, SP, Brazil
  • Cristina Coimbra Cunha
    Residência Médica em Oftalmologia, Faculdade de Medicina da Universidade Federal do Pará, Belém, PA, Brazil
    Departamento de Oftalmologia e Ciências Visuais, Universidade Federal de Sao Paulo, Sao Paulo, SP, Brazil
  • Nivea Nunes Cavascan
    Departamento de Oftalmologia e Ciências Visuais, Universidade Federal de Sao Paulo, Sao Paulo, SP, Brazil
  • Paula Sacai
    Departamento de Oftalmologia e Ciências Visuais, Universidade Federal de Sao Paulo, Sao Paulo, SP, Brazil
  • Sergio Munoz
    Salud Publica, Universidad de La Frontera, Temuco, Chile
  • Rubens Belfort
    Departamento de Oftalmologia e Ciências Visuais, Universidade Federal de Sao Paulo, Sao Paulo, SP, Brazil
  • Solange Rios Salomao
    Departamento de Oftalmologia e Ciências Visuais, Universidade Federal de Sao Paulo, Sao Paulo, SP, Brazil
  • Footnotes
    Commercial Relationships   Adriana Berezovsky, None; Marcia Higashi, None; Arthur Fernandes, None; Paulo Henrique Morales, None; Joao Furtado, None; Sung Watanabe, None; Galton Carvalho Vasconcelos, None; Marcos Jacob Cohen, None; Jacob Moyses Cohen, None; Marcela Cypel, None; Cristina Cunha, None; Nivea Nunes Cavascan, None; Paula Sacai, None; Sergio Munoz, None; Rubens Belfort, None; Solange Salomao, None
  • Footnotes
    Support  Conselho Nacional de Desenvolvimento Científico e Tecnológico – CNPq, Brasília, Brasil, Programa Ciência sem Fronteiras (Grant # 402120/2012-4 to SRS, SM and JMF; Research Scholarships to SRS and RBJ); Fundação de Amparo à Pesquisa do Estado de São Paulo, FAPESP, São Paulo, Brasil (Grant # 2013/16397-7 to SRS); Sight First Program – Lions Club International Foundation (Grant # 1758 to SRS).
Investigative Ophthalmology & Visual Science June 2017, Vol.58, 4800. doi:
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      Adriana Berezovsky, Marcia Higashi, Arthur Gustavo Fernandes, Paulo Henrique Morales, Joao M Furtado, Sung Watanabe, Galton Carvalho Vasconcelos, Marcos Jacob Cohen, Jacob Moyses Cohen, Marcela Cypel, Cristina Coimbra Cunha, Nivea Nunes Cavascan, Paula Sacai, Sergio Munoz, Rubens Belfort, Solange Rios Salomao; Anterior Segment Digital Photography Accuracy in the Evaluation of Pterygium: The Brazilian Amazon Region Eye Survey (BARES). Invest. Ophthalmol. Vis. Sci. 2017;58(8):4800.

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

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Abstract

Purpose : Pterygium is an eye disease that occurs more commonly in tropical regions, associated with chronic sun exposure and specifically to ultraviolet light. Our purpose was to determine agreement between anterior segment digital photography and eye exam for pterygium evaluation.

Methods : BARES is a population-based cross-sectional prospective study conducted in Parintins city. Participants were residents ≥45 years of age identified through a door-to-door interview. Eligible participants were invited for an eye exam. Pterygium occurrence and severity were assessed by ophthalmologists through slit-lamp examination considering its location (nasal - N, temporal - T or both - N&T), size (> 3 mm) and pupillary invasion. Participants from 8 urban and 4 rural clusters with pterygium had anterior segment photography obtained from each eye using a digital camera system (iCam, Optovue) with natural pupils on the same day. Images were analyzed off-line by a masked experienced ophthalmologist using the same grading system from the ophthalmic exam. The level of agreement of studied variables was determined by both percentage agreement and kappa statistic agreement. Clinical exam was used as gold-standard to determine sensitivity, specificity, positive and negative predictive values of anterior segment photography for pterygium detection.

Results : A total of 2384 persons was enumerated and 2041 were examined. Anterior segment photography was taken from 716 (35.1%) participants, 307 (42.9%) urban and 409 (57.1%) rural. Good agreement was found for pterygium location (k=0.69 N, k=0.81 T and k=0.77 N&T). Moderate agreement was found for size > 3 mm (k=0.39 N; k=0.29 T; k= 0.14 N&T) and pupillary invasion (k= 0.53). Overall, good sensitivity ranging from 59.5% to 91.6% (except for lesions >3mm), and high specificity (78.2% a 99.8%) were found. Positive predictive values ranged from 50.0% (pupillary invasion) to 92.5% (nasal > 3mm) whereas negative predictive values ranged from 76.8 (nasal lesion) to 98.8% (pupillary invasion).

Conclusions : There was moderate-to-substantial agreement between anterior segment digital photography and a comprehensive eye exam for pterygium evaluation. Anterior segment digital photography showed good accuracy and may be a useful tool for identification of pterygium and its severity in regions with limited access to eye care services.

This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.

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