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Detection of visual field defects by opticians - with Damato Multifixation Campimetry Online
摘要： Purpose: To study Damato Multifixation Campimetry Online (DMCO), an inexpensive online visual field test, used for screening at optician shops in Denmark. Methods: This was an evaluation of a diagnostic test and customers were included if minimum 50 years old, with a visual acuity of minimum 0.5 and with less myopia than 6 D. Standard equipment was a computer, a wireless mouse and a computer monitor. We used the 'DMCO STANDARD 4,5' algorithm for screening. DMCO results were electronically transmitted to the authors. Customers with a positive DMCO test received an eye examination including the reference standard Humphrey Visual Field Analyzer 30–2 SITA Fast test. A subset of control participants with a negative DMCO test received the same examination in order to estimate the number of false and true negatives. DMCO specificity and sensitivity were estimated according to five reference standards with 95% confidence intervals. Results: The population comprised 627 individuals, 381 women and 246 men, from 13 optician shops. Mean age was 62 years (SD 7.4). DMCO was positive in 32 individuals and 27 individuals were classified as 'true positives' with diagnoses such as glaucoma, cataract and neurological visual field defects. Of the 595 individuals with a negative DMCO test, 110 were examined and nine individuals were classified as 'false negatives' according to diagnoses. Depending on reference the specificity was 97–99% and sensitivity was 14–69%. Conclusion: Screening with DMCO demonstrated high specificity, whereas sensitivity was unsatisfactory. Future studies with enough power to estimate the true sensitivity is needed.
关键词： Humphrey Field Analyzer,glaucoma,screening test,Damato Multifixation Campimetry Online,specificity,opticians/optometrists
更新于2025-09-23 15:23:52
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Diagnostic Performance of Peripapillary Retinal Nerve Fiber Layer Thickness for Detection of Glaucoma in an Elderly Population: The ALIENOR Study
摘要： PURPOSE. To assess diagnostic accuracy of spectral-domain optical coherence tomography (SD-OCT) to discriminate glaucoma and control subjects in an elderly population. METHODS. The antioxidants, essential lipids, nutrition and ocular maladies study (ALIENOR: ‘‘Antioxydants, Lipides Essentiels, Nutrition et Maladies Oculaires’’) is a population-based study. From 2009 to 2010, a total of 624 subjects, aged 74 years or older underwent a complete eye examination, including optic disc color photography and SD-OCT examination of the macula and the optic nerve head. Glaucoma diagnosis was made using retinophotography of the optic nerve head and International Society for Epidemiologic and Geographical Ophthalmology criteria. Average and sectorial peripapillary retinal nerve ?ber layer thicknesses (RNFLT) were compared between glaucoma and control subjects using area under the receiver operating characteristic curves (AUC), positive and negative likelihood ratios (LRt/LR(cid:2)), and diagnostic odds ratios (DOR). RESULTS. A total of 532 subjects had complete data, 492 were classi?ed as controls and 40 were classi?ed as glaucoma. Mean age was 82.1 6 4.2 years and average RNFLT was signi?cantly different between both groups (controls: 88.7 6 12.2 lm, glaucoma: 65.4 6 14.4 lm, P < 0.001). Highest AUC values were observed for average (0.895), temporal-inferior (0.874), and temporal-superior (0.868) RNFLT. Temporal-superior RNFLT had the highest DOR (25.31; LRt, 4.65; LR(cid:2), 0.18), followed by average RNFLT (DOR: 24.80; LRt, 6.36; LR(cid:2), 0.26). When using the normative database provided by the machine, DOR increased to 31.03 (LRt, 1.75; LR(cid:2), 0.06) if at least one parameter was considered abnormal (at P < 0.05). CONCLUSIONS. Parameters of SD-OCT RNFL may provide valuable information in a screening strategy to improve glaucoma detection in a general population of elderly people.
关键词： spectral-domain OCT,OCT,optical coherence tomography,glaucoma screening,likelihood ratios,aging
更新于2025-09-04 15:30:14