Laterality of the performance of glaucoma mass screening using frequency-doubling technology.
OBJECTIVE
This study investigated laterality during the performance of glaucoma mass screening with a frequency-doubling technology perimetry test.


METHODS
A frequency-doubling technology screening mode (C-20-1, version 2.6) test was performed on both eyes of 14,784 persons. Subjects with visual field abnormalities detected by the frequency-doubling technology test or with fixation error underwent retesting without a specified interval for rest. Consequently, 206 subjects who fulfilled the screening criteria of the frequency-doubling technology-based glaucoma screening protocol [FDT-GSP(+)] were further investigated using the Humphrey visual field analyzer (30-2). As a result, 74 right eyes and 57 left eyes were shown to have definite glaucoma.


RESULTS
Frequency-doubling technology data for the left eye demonstrated a significantly (P<0.001) higher rate of artifacts, such as no reproducibility of results between the first and second tests (left/right: 2.4%/1.7%) as well as fixation errors (left/right: 2.8%/1.0%). The false-positive rate of the FDT-GSP for glaucoma was more than 1.5-fold higher in the left eye than in the right eye (16.3%/9.8%). In the case that either eye exhibited FDT-GSP(+), the positive predictive value of the FDT-GSP for definite glaucoma in the left eye was almost half of that in the right eye (28.4% vs. 53.8%). Specificity of the FDT-GSP for detection of definite glaucoma also exhibited a lower trend (P = 0.097) in the left eye (44.6%) than in the right eye (55.3%), but the sensitivity of the test was similar in both eyes (91.2% vs. 90.5%, respectively).


CONCLUSIONS
When frequency-doubling technology-based mass screening is performed on the general population, performance is lower for the left eye than for the right eye. This performance disparity is likely to be primarily associated with a difference in specificity.
Tatemichi
Masayuki
M
Department of Environmental and Occupational Health, Toho University School of Medicine, 5-21-16 Omori-nishi, Otaku, Tokyo 143-8540, Japan. tatemich@med.toho-u.ac.jp
Nakano
Tadashi
T
Tanaka
Katsutoshi
K
Hayashi
Takeshi
T
Nawa
Takeshi
T
Iwasaki
Akio
A
Miyamoto
Toshiaki
T
Hiro
Hisanori
H
Sugita
Minoru
M
D000328:Adult; D016477:Artifacts; D005123:Eye / Q000503:physiopathology*; D005189:False Positive Reactions; D005260:Female; D007839:Functional Laterality; D005901:Glaucoma / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D058609:Visual Field Tests / Q000379:methods