Abstract
Purpose :
Prioritizing the most urgent cases in cataract waiting lists requires practical, economical solutions. In this study, we investigate the feasibility of using a mail-delivered, pen-and-paper contrast sensitivity (CS) test to potentially flag eyes that require surgery.
Methods :
The SpotChecks TM CS test (Figure 1[A] and [B]) was mailed to patients (n=233) waiting for their cataract assessment, along with a prepaid return envelope (cross-sectional study). Response rates were tabulated (stratified by age, sex, and socioeconomic status), and test scores were analysed to determine how well the home-tests predicted which eyes were referred for surgery. A subset of these patients (n=39) underwent in-person follow-up testing to verify the accuracy of the home data.
Results :
Forty-six per cent of patients responded (n=108). No notable differences were noted between respondents and non-respondents, either in terms of age, sex, geographic location, or socioeconomic status (all p > 0.05, Figure 2[A],[B],[C], and [D]). The home-test CS scores had an AUROC {± CI 95%} of 0.69 {0.61 – 0.76} for predicting which eyes were later listed for surgery. Machine learning was used to combine CS scores with the patient’s visual acuity (extracted from the patient’s medical record) to further improve the prediction (AUROC {± CI 95%} = 0.77 {0.70 – 0.83}). Follow-up testing in a subset of patients (n=39) indicated home CS scores correlated with other clinical measurements including biometry signal-to-noise ratio (p = 0.032), LogMAR acuity, and Pelli-Robson CS (all p < 0.001).
Conclusions :
Mailing patients pen-and-paper CS tests may be a feasible, “low-tech” way of helping assign priority to patients on cataract waiting lists.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.