July 2019
Volume 60, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2019
Glaucoma detection with OCT and nerve photographs in a population-based telemedicine program: findings, diagnostic accuracy and influencing factors.
Author Affiliations & Notes
  • Alfonso Anton-Lopez
    Universitat Internacional de Catalunya, Institut Catalá de Retina and Parc Salut Mar, Barcelona, Spain
  • gianluca fatti
    Parc de Salut Mar, Spain
    Hospital Valle Hebron, Spain
  • karen Nolivos
    Parc de Salut Mar, Spain
  • alejandra herranz
    Parc de Salut Mar, Spain
  • Zaida Vega-Lopez
    Parc de Salut Mar, Spain
  • Eleonora Ayala
    Institut Catala de Retina, Spain
  • Ana Martinez-Palmer
    Parc de Salut Mar, Spain
  • Isaac Alarcon
    Parc de Salut Mar, Spain
  • Vladimir Popovski
    Parc de Salut Mar, Spain
    Institut Catala de Retina, Spain
  • Marta Pazos-Lopez
    Hospital Clínico de Barcelona, Spain
  • Saideh Khaouli
    Parc de Salut Mar, Spain
  • Katia Sotelo
    Institut Catala de Retina, Spain
  • Natasa Zmuc
    Zmuc Pharma Consulting, Slovenia
  • Virginia Garcia
    Institut Catala de Retina, Spain
  • Merce Comas
    Parc de Salut Mar, Spain
  • Xavier Castells
    Parc de Salut Mar, Spain
  • Footnotes
    Commercial Relationships   Alfonso Anton-Lopez, Alcon (C), Alcon (R), Bausch (C), BrudyLab (F), Santen (C), Santen (R), Thea (C), Thea (R); gianluca fatti, None; karen Nolivos, None; alejandra herranz, None; Zaida Vega-Lopez, None; Eleonora Ayala, None; Ana Martinez-Palmer, None; Isaac Alarcon, None; Vladimir Popovski, None; Marta Pazos-Lopez, None; Saideh Khaouli, None; Katia Sotelo, None; Natasa Zmuc, None; Virginia Garcia, None; Merce Comas, None; Xavier Castells, None
  • Footnotes
    Support  Fondo de Investigaciones Sanitarias (PI15/00412)
Investigative Ophthalmology & Visual Science July 2019, Vol.60, 5541. doi:
  • Views
  • Share
  • Tools
    • Alerts
      This feature is available to authenticated users only.
      Sign In or Create an Account ×
    • Get Citation

      Alfonso Anton-Lopez, gianluca fatti, karen Nolivos, alejandra herranz, Zaida Vega-Lopez, Eleonora Ayala, Ana Martinez-Palmer, Isaac Alarcon, Vladimir Popovski, Marta Pazos-Lopez, Saideh Khaouli, Katia Sotelo, Natasa Zmuc, Virginia Garcia, Merce Comas, Xavier Castells; Glaucoma detection with OCT and nerve photographs in a population-based telemedicine program: findings, diagnostic accuracy and influencing factors.. Invest. Ophthalmol. Vis. Sci. 2019;60(9):5541.

      Download citation file:

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

  • Supplements

Purpose : To describe the findings, to assess diagnostic accuracy and to analyze the factors influencing the detection process.

Methods : A telemedicine web-based platform (DYSEO) was designed and developed to enable specialists to remotely evaluate images. Four thousand subjects over 55 years were randomly selected by age and gender groups from the sanitary census and invited to participate. Measures of visual acuity and ocular pressure were obtained, and macular and optic disks images were acquired with a non-mydriatic retinograph (Topcon) and a portable SD-OCT (iVue, Optóvue). Eight ophthalmologists evaluated the cases on a deferred basis and the report was automatically sent to the primary care center (PCC) with an ocular health advice. Definite diagnosis was established in a second complete ophthalmic examination (including gonioscopy and visual field) at the Hospital. All patients screened were invited to be examined at Hospital. Descriptive statistics were applied. Sensitivity, specificity and predictive values were calculated.

Results : After a phone call, 1655 subjects initially accepted to participate in the study and, of these, 1006 (60%) did attend and were fully screened at PCC. The quality of the images was good in 69.8 % for the retinographies and 92.5% for optic disk’s OCTs. The screening program identified 195 cases (19.4%) with suspicion of glaucoma. The number of cases detected increased with increasing age (p< 0.005). Optic disc photographs and OCT were classified as suspicious of glaucoma in 128 (12.7%) and 127 (12.6%), respectively with a Kappa agreement index of 0.37. A total of 481 subjects (48%) were fully examined at the hospital. Global sensitivity, specificity, negative predictive value and positive predictive value were 70.1%, 97.4%, 84% and 94.4%, respectively. Diagnostic accuracy of screening increased with increasing age, greater glaucoma severity and with expert evaluators (p< 0.05).

Conclusions : The screening program identified glaucoma suspects in 19.4% of cases examined and offered high specificity and predictive values to detect glaucoma. Agreement between photographs’ and OCT images’ evaluation was moderate but they offered additive information.

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.


This PDF is available to Subscribers Only

Sign in or purchase a subscription to access this content. ×

You must be signed into an individual account to use this feature.