Abstract
Objective: We examined a screening procedure for glaucoma in health check-ups where Frequency Doubling Technology Perimetry (FDT) was conducted together with fundus examination (exam) and tonometry.
Methods: In the period from June 2011 to December 2014, 6,930 of 49,442 persons undergoing ophthalmologic exams (FDT, fundus exam, tonometry) in health check-ups at Omiya City Clinic were observed to have abnormalities. These were our subjects and we retrospectively compared the final diagnoses made in subsequent more precise ophthalmologic exams.
Results: We found that the final diagnosis was glaucoma in 1,159 subjects and in 485 of them the glaucoma was newly diagnosed. The numbers of persons with abnormalities in each exam were 426 for FDT, 428 for fundus exam and 5 for tonometry. The numbers of examinees with abnormalities in FDT only, fundus exam only and tonometry only were 57, 52 and 1, respectively. The feature of persons with abnormalities in FDT only was that signs of glaucoma tended to be difficult to detect from fundus photographs due to a myopic fundus. That of persons with abnormalities in fundus exam only was a tendency toward narrowing of the retinal nerve fiber defect region in fundus photographs. The positive predictive value for each exam was 30.6% for FDT, 58.2% for fundus exam and 42.4% for tonometry, and for people who were finally diagnosed with glaucoma, abnormality detection rates for FDT, fundus exam and tonometry were 89.5%, 88.4% and 1.0%, respectively.
Conclusions: FDT was considered to be useful in glaucoma screening in health check-ups. On the other hand, as there were many examinees who were normal in FDT but had an abnormality in fundus exam only or were normal for fundus exam but had an abnormality in FDT only, in the present situation, the 2 exams should be conducted together.
