Glaucoma screening in the elderly in Bao′an District street of Shenzhen

Abstract

Objective To explore the early diagnosis and prevention measures of glaucoma in the elderly of street. Methods The clinical data of 364 eyes of elderly patients with suspected glaucoma in the ophthalmology outpatient department of Songgang people′s Hospital of Baoan District, Shenzhen, from August 2015 to February 2016 were retrospectively analyzed. All subjects received visual acuity, intraocular pressure, ocular A and slit lamp microscopy. For those with positive results, glaucoma special examination is continued. It includes 24 h intraocular pressure, anterior chamber angle, field of view, optical coherence tomography (OCT) and ultrasound biomicroscopy (UBM). The description of the glaucoma diagnosis and the description of the early examination project adopted the number and percentage of the eyes, and the sensitivity, specificity, accuracy, positive predictive value, negative predictive value and Youden index were calculated for the diagnosis of glaucoma. Chi square test was used to compare the sensitivity, specificity, accuracy, positive predictive value and negative predictive value of each item in diagnosing glaucoma. Results In the 364 eyes, 89 eyes were diagnosed as open angle glaucoma, 97 eyes with angle closure glaucoma, 27 eyes with other fundus diseases, 31 eyes and 110 normal eyes, which accounted for 24.4%, 26.6%, 7.4%, 8.5% and 30.2%, respectively. 364 eyes received 906 times of glaucoma special examination, with an average of (2.49±1.02)times. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of each examination were statistically significant (χ2=66.73, 13.41, 47.08, 11.90, 44.20; P<0.05). The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of 24 h intraocular pressure and OCT examination in the special examination of senile glaucoma were higher than that of the angle lens, the visual field and the UBM examination. Conclusion OCT and 24h IOP examination are an ideal special screening item for glaucoma screening in elderly people. It is necessary to establish and improve the tertiary prevention measures for aged glaucoma in the street and realize the aim of prevention and early diagnosis and treatment of glaucoma. Key words: Street elderly; Glaucoma; Early diagnosis; Prevention measures