FDT Perimetry for Glaucoma Detection in Comprehensive Health Checkup Service.

Ryo Terauchi,Tomohiro Kato,Takashi Wada,Shumpei Ogawa,Tadashi Nakano,Masanobu Kaji,Masayuki Tatemichi

doi:10.1155/2020/4687398

Abstract

We aimed to investigate the efficacy of frequency doubling technology (FDT) perimetry for glaucoma detection in comprehensive screening examinations. We performed a retrospective analysis of prospectively collected data of participants who underwent a comprehensive health checkup service. Participants with glaucoma were excluded. In the first year, 2024 participants (46.8 ± 9.4 years) who underwent FDT perimetry and fundus photography were classified as the FDT group, whereas 3052 participants (42.2 ± 8.2 years) who underwent only fundus photography were classified as the non-FDT control group. Participants with abnormal findings on FDT perimetry and/or fundus photography were recommended to undergo further complete examination. All participants reported whether they had been newly diagnosed with glaucoma within 2 years of the first visit. In the FDT group, 23 (1.14%) participants were newly diagnosed with glaucoma. Among them, 20 (87.0%) had abnormal FDT perimetry findings and 12 (52.2%) had abnormal findings on fundus photography. The positive-predictive value (PPV) of FDT perimetry was 16.5% (20/121) and that of fundus photography was 13.3% (12/90). In participants with abnormal findings on both tests, the PPV was 26.2%. In the non-FDT group, 15 (0.49%) participants were newly diagnosed with glaucoma. Among them, 9 (60.0%) had abnormal findings on fundus photography. The PPV of fundus photography was 10.8% (9/83). The glaucoma detection rate, analyzed using age adjustment, was significantly higher in the FDT group than that in the non-FDT group (0.97% versus 0.47%, P=0.041). FDT perimetry, even if performed by nonspecialized physicians, could improve glaucoma detection when used in addition to fundus photography. This study was registered with UMIN000037951.

Highlights

Glaucoma is a group of eye diseases that damage the optic nerve, resulting in characteristic visual field defects
Among the 23 participants diagnosed with glaucoma, 20 (87.0%) had a positive frequency doubling technology (FDT) perimetry test. e positive-predictive value (PPV) of fundus photography was 13.3% (12/90)
We demonstrated that FDT perimetry, even if performed by general physicians not specialized in ophthalmology, could improve glaucoma detection in comprehensive health checkup service, in combination with fundus photography

Summary

Introduction

Glaucoma is a group of eye diseases that damage the optic nerve, resulting in characteristic visual field defects. It is estimated that the total number of glaucoma cases worldwide will rise to 79.6 million in 2020 and 111.8 million in 2040 [1, 2]. NTG is often detected in the advanced stage with severe visual field defects because almost all patients have no subjective symptoms, in the early and less advanced stages of the disease. E Tajimi study, a population-based prevalence survey of glaucoma in Japan, estimated that 95.5% of the NTG cases were previously undiagnosed [4]. Glaucomatous visual field defects are progressive and irreversible, early detection can enable prevention of these defects. Glaucomatous visual field defects are progressive and irreversible, early detection can enable prevention of these defects. erefore, early detection of glaucomatous changes and early treatment intervention are very important

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