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Anton A, Nolivos K, Pazos M, Fatti G, Ayala ME, Martínez-Prats E, Peral O, Poposki V, Tsiroukis E, Morilla-Grasa A, Comas M, Castells X. Diagnostic Accuracy and Detection Rate of Glaucoma Screening with Optic Disk Photos, Optical Coherence Tomography Images, and Telemedicine. J Clin Med 2021; 11:jcm11010216. [PMID: 35011957 PMCID: PMC8746039 DOI: 10.3390/jcm11010216] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 12/26/2021] [Accepted: 12/28/2021] [Indexed: 11/16/2022] Open
Abstract
Purpose: The aim of this study was to evaluate the diagnostic accuracy of optical coherence tomography (OCT) and retinography in the detection of glaucoma through a telemedicine program. Methods: A population-based sample of 4113 persons was randomly selected. The screening examination included a fundus photograph and OCT images. Images were evaluated on a deferred basis. All participants were then invited to a complete glaucoma examination, including gonioscopy, visual field, and dilated fundus examination. The detection rate, sensitivity, specificity, and positive and negative predictive values were calculated. Results: We screened 1006 persons. Of these, 201 (19.9%) were classified as glaucoma suspects; 20.4% were identified only by retinographs, 11.9% only by OCT images, and 46.3% by both. On ophthalmic examination at the hospital (n = 481), confirmed glaucoma was found in 58 (12.1%), probable glaucoma in 76 (15.8%), and ocular hypertension in 10 (2.1%), and no evidence of glaucoma was found in 337 (70.0%). The detection rate for confirmed or probable glaucoma was 9.2%. Sensitivity ranged from 69.4% to 86.2% and specificity from 82.1% to 97.4%, depending on the definition applied. Conclusions: The combination of OCT images and fundus photographs yielded a detection rate of 9.2% in a population-based screening program with moderate sensitivity, high specificity, and predictive values of 84–96%.
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Affiliation(s)
- Alfonso Anton
- Research Department, Institut Català de la Retina (ICR), 08017 Barcelona, Spain; (M.E.A.); (V.P.); (E.T.); (A.M.-G.)
- Medical School, Universitat Internacional de Catalunya, 08017 Barcelona, Spain
- Ophthalmology Service, Parc de Salut Mar, 08005 Barcelona, Spain;
- Correspondence: ; Tel.: +34-93-254-0565 (ext. 4000-4002); Fax: +34-93-254-0567
| | - Karen Nolivos
- Department of Medicine, Institut Mar d’Investigacions Mèdiques (IMIM), 08005 Barcelona, Spain;
- Epidemiology and Evaluation Department, Parc Salut Mar, 08005 Barcelona, Spain; (M.C.); (X.C.)
| | - Marta Pazos
- Institut Clínic d’Oftalmologia (ICOF), Hospital Clínic de Barcelona, Institut d’Investigacions Mèdiques, 08036 Barcelona, Spain;
| | - Gianluca Fatti
- Ophthalmology Service, Parc de Salut Mar, 08005 Barcelona, Spain;
| | - Miriam Eleonora Ayala
- Research Department, Institut Català de la Retina (ICR), 08017 Barcelona, Spain; (M.E.A.); (V.P.); (E.T.); (A.M.-G.)
| | | | | | - Vladimir Poposki
- Research Department, Institut Català de la Retina (ICR), 08017 Barcelona, Spain; (M.E.A.); (V.P.); (E.T.); (A.M.-G.)
- Ophthalmology Service, Parc de Salut Mar, 08005 Barcelona, Spain;
| | - Evangelos Tsiroukis
- Research Department, Institut Català de la Retina (ICR), 08017 Barcelona, Spain; (M.E.A.); (V.P.); (E.T.); (A.M.-G.)
| | - Antonio Morilla-Grasa
- Research Department, Institut Català de la Retina (ICR), 08017 Barcelona, Spain; (M.E.A.); (V.P.); (E.T.); (A.M.-G.)
| | - Merce Comas
- Epidemiology and Evaluation Department, Parc Salut Mar, 08005 Barcelona, Spain; (M.C.); (X.C.)
- Health Services Research on Chronic Patients Network (REDISSEC), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Xavier Castells
- Epidemiology and Evaluation Department, Parc Salut Mar, 08005 Barcelona, Spain; (M.C.); (X.C.)
- Health Services Research on Chronic Patients Network (REDISSEC), Instituto de Salud Carlos III, 28029 Madrid, Spain
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