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The Additional Yield Of A Periodic Screening Programme For Open-angle Glaucoma: A Population-based Comparison Of Incident Glaucoma Cases Detected In Regular Ophthalmic Care With Cases Detected During Screening

R. Stoutenbeek, S. de Voogd, R. Wolfs, A. Hofman, P. T. D. de Jong, N. Jansonius
Published 2008 · Medicine

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Aim: To study the additional yield of a periodic screening programme for open-angle glaucoma (OAG) by comparing, in a population-based setting, incident OAG (iOAG) cases detected in regular ophthalmic care with those detected during screening. Methods: Participants aged 55 and over from the population-based Rotterdam Study underwent the same ophthalmic examination at baseline (1991–3) and follow-up (1997–9), including visual field testing and simultaneous stereo optic disc photography. Of 3842 participants, 87 (2.3%) developed iOAG during a mean follow-up time of 6.5 years. Of these 87 iOAG cases, 78 (90%) were included in this study. Results: Of the 78 iOAG cases detected at follow-up, 23 (29%) had already been detected before during regular ophthalmic care. The remaining 55 (71%) undetected iOAG cases more often showed glaucomatous optic neuropathy without glaucomatous visual field loss (29 of 55 (53%)) as compared with the detected cases (four of 23 (17%); p = 0.009). Of the undetected iOAG cases, only four had developed significant visual field loss in their better eye. Conclusion: The additional yield of a periodic OAG screening programme is lower than expected from published prevalence data. In the discussion, the authors estimate that—in a white population with a low prevalence of pseudoexfoliation—about one in 1000 screened persons could be saved from bilateral end-stage OAG.
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