Glaucoma screening: analysis of conventional and telemedicine-friendly devices
Purpose: Portable, telemedicine-friendly devices offer novel opportunity for screening and monitoring glaucoma in the remote and rural regions of the world. This study examines the effective combination of telemedicine-friendly screening devices for detection of glaucoma in relation with conventional, hospital-based devices.
Methods: A total of 399 eyes were screened with telemedicine-friendly devices and conventional, hospital-based devices such as ophthalmoscope, tonometer and perimeter.
Results: Combination of age and family history of glaucoma alone has a sensitivity of 35.6% (specificity 94.2%, area under the curve 0.81, correctly classified 81.1%) and an addition of telemedicine-friendly or conventional visual field tests optimized the sensitivity to 91.1% (specificity 93.6%, area under the curve 0.95, correctly classified 93%). Analysis indicates good agreement between vertical cup-to-disc ratio by ophthalmoscopy and digital image reading. An addition of intraocular pressure test does not change sensitivity (35.6%) and specificity (94.2%).
Conclusion: This study indicates that evaluations of cup-to-disc ratio and visual field, using telemedicine-friendly devices, are most useful tools in screening for glaucoma. When used together these devices may be an alternative for conventional glaucoma screenings.
Kumar, S., Giubilato, A., Morgan, W., Jitskaia, L., Barry, C., Bulsara, M., et al. (2007). Glaucoma screening: Analysis of conventional and telemedicine-friendly devices. Clinical and Experimental Ophthalmology, 35(3), 237-243. doi: 10.1111/j.1442-9071.2007.01457.x