Yuanbo Liang1, Junhong Jiang2, Wen Ou3, Xianyao Peng2, Ruizhu Sun3, Xiang Xu3, Juanyuan Yang3, Cheng Hu3, Cong Ye3, Nathan Congdon4, Fan Lu5. 1. The Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China; Centre for Public Health, Queen's University Belfast, Belfast, United Kingdom. 2. The Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China; Ningbo Eye Hospital, Ningbo, Zhejiang, China. 3. The Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China. 4. Centre for Public Health, Queen's University Belfast, Belfast, United Kingdom; Division of Preventive Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China; Orbis International, New York, New York, USA. 5. The Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, China. Electronic address: lufan@mail.eye.ac.cn.
Abstract
PURPOSE: To assess differences in clinical and demographic characteristics between glaucoma patients identified by community screening and those newly diagnosed in hospital in a Chinese setting. DESIGN: Prospective comparative cohort study. METHODS: A total of 373 patients identified with glaucoma among 27 000 persons undergoing community screening were enrolled as the Screening group. The Clinic group consisted of 119 consecutively presenting, newly diagnosed glaucoma patients in hospital. Primary outcomes were mean deviation (MD), visual field index (VFI) and pattern standard deviation (PSD) on Humphrey Field Analyzer, and intraocular pressure (IOP). Disease severity was categorized into 5 stages based on MD. RESULTS: A total of 89.6% (328/373) of Screening group patients had IOP < 21 mm Hg, compared to 48.7% (58/119) in the Clinic group (P < .001). The mean VFI, MD, and PSD were 76.4% ± 23.8%, -9.7 ± 7.3 dB, and 6.4 ± 3.4 dB in the Screening group and significantly worse in the Clinic group: 44.1% ± 32.0%, -19.8 ± 9.5 dB, and 7.6 ± 3.1 dB (P < .001 for MD and VFI, P = .001 for PSD). Nearly three quarters of Screening patients had early or moderate visual field loss (monocular), while nearly half of Clinic patients had severe loss at the time of diagnosis. Screening patients were significantly more likely to be older (P < .001) and female (P < .001) than Clinic patients. CONCLUSION: Glaucoma patients detected through community screening had significantly milder damage, and were more likely to include underserved groups (women, elderly) than those newly diagnosed in a clinic in this setting. Comparison with population studies suggests that cases of glaucoma with IOP < 21 mm Hg are severely underascertained in China, a situation that may be improved by screening.
PURPOSE: To assess differences in clinical and demographic characteristics between glaucomapatients identified by community screening and those newly diagnosed in hospital in a Chinese setting. DESIGN: Prospective comparative cohort study. METHODS: A total of 373 patients identified with glaucoma among 27 000 persons undergoing community screening were enrolled as the Screening group. The Clinic group consisted of 119 consecutively presenting, newly diagnosed glaucomapatients in hospital. Primary outcomes were mean deviation (MD), visual field index (VFI) and pattern standard deviation (PSD) on Humphrey Field Analyzer, and intraocular pressure (IOP). Disease severity was categorized into 5 stages based on MD. RESULTS: A total of 89.6% (328/373) of Screening group patients had IOP < 21 mm Hg, compared to 48.7% (58/119) in the Clinic group (P < .001). The mean VFI, MD, and PSD were 76.4% ± 23.8%, -9.7 ± 7.3 dB, and 6.4 ± 3.4 dB in the Screening group and significantly worse in the Clinic group: 44.1% ± 32.0%, -19.8 ± 9.5 dB, and 7.6 ± 3.1 dB (P < .001 for MD and VFI, P = .001 for PSD). Nearly three quarters of Screening patients had early or moderate visual field loss (monocular), while nearly half of Clinic patients had severe loss at the time of diagnosis. Screening patients were significantly more likely to be older (P < .001) and female (P < .001) than Clinic patients. CONCLUSION:Glaucomapatients detected through community screening had significantly milder damage, and were more likely to include underserved groups (women, elderly) than those newly diagnosed in a clinic in this setting. Comparison with population studies suggests that cases of glaucoma with IOP < 21 mm Hg are severely underascertained in China, a situation that may be improved by screening.
Authors: Doaa Maamoun Ashour; Mohamed Ibrahim Saleh; Mo'mena Ahmad A Awad-Allah; Randa H A Abdelgawad Journal: Int Ophthalmol Date: 2021-02-02 Impact factor: 2.031