Integrating opportunistic glaucoma screening into general health examinations in China: A pilot study

Shaodan Zhang*, Jing Sun, Shanshan Liu, Yuanbo Liang, Ying Hu, Nathan Congdon, Chi Pui Pang, Hailin Wang

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

13 Citations (Scopus)

Abstract

Importance: Under-detection and late diagnosis are major causes of glaucoma-related visual impairment. Cost-effective opportunistic glaucoma screening is of great interest in the early identification and prevention of glaucoma.

 Background: To describe the results of a health examination centre-based opportunistic glaucoma screening and referral model. 

Design: This single centre cross-sectional study was conducted in a health examination centre affiliated to a tertiary hospital in Shenyang, northeastern China. 

Participants: From 21 March to 30 September 2016, 14 367 individuals aged ≥ 30 years undergoing routine physical examinations were invited for this glaucoma screening. 

Methods: Presenting visual acuity, non-contact pneumotonometry and non-mydriatic fundus photography were evaluated. Fundus photographs were classified as non-glaucoma, possible, probable and definitive glaucoma. Participants with probable and definite glaucomatous discs or intraocular pressure ≥ 24 mmHg were referred for definitive examinations. 

Main Outcome Measures: Detection rate of glaucoma suspects and ocular hypertension (OHT). Cost to identify a single case with suspected and diagnosed glaucoma was also calculated. 

Results: Altogether, 277 glaucoma suspects and 327 ocular hypertension suspects were identified. Among 190 participants with probable/definite glaucomatous discs, 93 (48.9%) accepted further examination. Among these, 78 were diagnosed as glaucoma, seven as suspects and eight were excluded. Only 98 ocular hypertension suspects (30.0%) accepted further examinations: eight had primary angle closure and 23 had confirmed ocular hypertension. The cost to identify a single glaucoma suspect and definite glaucoma case were US$135 and US$857, respectively. 

Conclusions and Relevance: This novel screening model provides opportunities to improve glaucoma detection at low cost. Interventions to improve follow-up are needed.

Original languageEnglish
Pages (from-to)1000-1008
Number of pages9
JournalClinical and Experimental Ophthalmology
Volume47
Issue number8
Early online date20 Jun 2019
DOIs
Publication statusPublished - 21 Nov 2019

Bibliographical note

Publisher Copyright:
© 2019 Royal Australian and New Zealand College of Ophthalmologists

Keywords

  • glaucoma
  • health examination centre
  • opportunistic screening

ASJC Scopus subject areas

  • Ophthalmology

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