Evaluating the outcome of screening for glaucoma using colour fundus photography-based referral criteria in a teleophthalmology screening programme for diabetic retinopathy
© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ..
AIMS: To evaluate the effectiveness of glaucoma screening using glaucoma suspect (GS) referral criteria assessed on colour fundus photographs in Singapore's Integrated Diabetic Retinopathy Programme (SiDRP).
METHODS: A case-control study. This study included diabetic subjects who were referred from SiDRP with and without GS between January 2017 and December 2018 and reviewed at Singapore National Eye Centre. The GS referral criteria were based on the presence of a vertical cup-to-disc ratio (VCDR) of ≥0.65 and other GS features. The final glaucoma diagnosis confirmed from electronic medical records was retrospectively matched with GS status. The sensitivity, specificity and positive predictive value (PPV) of the test were evaluated.
RESULTS: Of 5023 patients (2625 with GS and 2398 without GS) reviewed for glaucoma, 451 (9.0%, 95% CI 8.2% to 9.8%) were confirmed as glaucoma. The average follow-up time was 21.5±10.2 months. Using our current GS referral criteria, the sensitivity, specificity and PPV were 81.6% (95% CI 77.7% to 85.1%), 50.6% (95% CI 49.2% to 52.1%) and 14.0% (95% CI 13.4% to 14.7%), respectively, resulting in 2257 false positive cases. Increasing the VCDR cut-off for referral to ≥0.80, the specificity increased to 93.9% (95% CI 93.1% to 94.5%) but the sensitivity decreased to 11.3% (95% CI 8.5% to 14.6%), with a PPV of 15.4% (95% CI 12.0% to 19.4%).
CONCLUSIONS: Opportunistic screening for glaucoma in a lower VCDR group could result in a high number of unnecessary referrals. If healthcare infrastructures are limited, targeting case findings on a larger VCDR group with high specificity will still be beneficial.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2023 |
|---|---|
| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - year:2023 |
|---|---|
| Enthalten in: |
The British journal of ophthalmology - (2023) vom: 18. Okt. |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Tan, Rose [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Diagnostic tests/Investigation |
|---|
| Anmerkungen: |
Date Revised 18.10.2023 published: Print-Electronic Citation Status Publisher |
|---|
| doi: |
10.1136/bjo-2023-323339 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM363452346 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM363452346 | ||
| 003 | DE-627 | ||
| 005 | 20231226093359.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231226s2023 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1136/bjo-2023-323339 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1211.xml |
| 035 | |a (DE-627)NLM363452346 | ||
| 035 | |a (NLM)37852739 | ||
| 035 | |a (PII)bjo-2023-323339 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Tan, Rose |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Evaluating the outcome of screening for glaucoma using colour fundus photography-based referral criteria in a teleophthalmology screening programme for diabetic retinopathy |
| 264 | 1 | |c 2023 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Revised 18.10.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status Publisher | ||
| 520 | |a © Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. | ||
| 520 | |a AIMS: To evaluate the effectiveness of glaucoma screening using glaucoma suspect (GS) referral criteria assessed on colour fundus photographs in Singapore's Integrated Diabetic Retinopathy Programme (SiDRP) | ||
| 520 | |a METHODS: A case-control study. This study included diabetic subjects who were referred from SiDRP with and without GS between January 2017 and December 2018 and reviewed at Singapore National Eye Centre. The GS referral criteria were based on the presence of a vertical cup-to-disc ratio (VCDR) of ≥0.65 and other GS features. The final glaucoma diagnosis confirmed from electronic medical records was retrospectively matched with GS status. The sensitivity, specificity and positive predictive value (PPV) of the test were evaluated | ||
| 520 | |a RESULTS: Of 5023 patients (2625 with GS and 2398 without GS) reviewed for glaucoma, 451 (9.0%, 95% CI 8.2% to 9.8%) were confirmed as glaucoma. The average follow-up time was 21.5±10.2 months. Using our current GS referral criteria, the sensitivity, specificity and PPV were 81.6% (95% CI 77.7% to 85.1%), 50.6% (95% CI 49.2% to 52.1%) and 14.0% (95% CI 13.4% to 14.7%), respectively, resulting in 2257 false positive cases. Increasing the VCDR cut-off for referral to ≥0.80, the specificity increased to 93.9% (95% CI 93.1% to 94.5%) but the sensitivity decreased to 11.3% (95% CI 8.5% to 14.6%), with a PPV of 15.4% (95% CI 12.0% to 19.4%) | ||
| 520 | |a CONCLUSIONS: Opportunistic screening for glaucoma in a lower VCDR group could result in a high number of unnecessary referrals. If healthcare infrastructures are limited, targeting case findings on a larger VCDR group with high specificity will still be beneficial | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Diagnostic tests/Investigation | |
| 650 | 4 | |a Glaucoma | |
| 650 | 4 | |a Public health | |
| 650 | 4 | |a Telemedicine | |
| 700 | 1 | |a Teo, Kelvin Yi Chong |e verfasserin |4 aut | |
| 700 | 1 | |a Husain, Rahat |e verfasserin |4 aut | |
| 700 | 1 | |a Tan, Ngiap Chuan |e verfasserin |4 aut | |
| 700 | 1 | |a Lee, Qian Xin |e verfasserin |4 aut | |
| 700 | 1 | |a Hamzah, Haslina |e verfasserin |4 aut | |
| 700 | 1 | |a Wong, Tina |e verfasserin |4 aut | |
| 700 | 1 | |a Aung, Tin |e verfasserin |4 aut | |
| 700 | 1 | |a Cheng, Ching Yu |e verfasserin |4 aut | |
| 700 | 1 | |a Lamoureux, Ecosse Luc |e verfasserin |4 aut | |
| 700 | 1 | |a Tan, Colin S |e verfasserin |4 aut | |
| 700 | 1 | |a Wong, Hon-Tym |e verfasserin |4 aut | |
| 700 | 1 | |a Wong, Tien Y |e verfasserin |4 aut | |
| 700 | 1 | |a Tan, Gavin Siew Wei |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t The British journal of ophthalmology |d 1917 |g (2023) vom: 18. Okt. |w (DE-627)NLM000087556 |x 1468-2079 |7 nnns |
| 773 | 1 | 8 | |g year:2023 |g day:18 |g month:10 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1136/bjo-2023-323339 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |j 2023 |b 18 |c 10 | ||