Glaucoma screening: analysis of conventional and telemedicine-friendly devices.
OBJECTIVE
Portable, telemedicine-friendly devices offer novel opportunity for screening and monitoring glaucoma in the remote and rural regions of the world. This study examines the effective combination of telemedicine-friendly screening devices for detection of glaucoma in relation with conventional, hospital-based devices.


METHODS
A total of 399 eyes were screened with telemedicine-friendly devices and conventional, hospital-based devices such as ophthalmoscope, tonometer and perimeter.


RESULTS
Combination of age and family history of glaucoma alone has a sensitivity of 35.6% (specificity 94.2%, area under the curve 0.81, correctly classified 81.1%) and an addition of telemedicine-friendly or conventional visual field tests optimized the sensitivity to 91.1% (specificity 93.6%, area under the curve 0.95, correctly classified 93%). Analysis indicates good agreement between vertical cup-to-disc ratio by ophthalmoscopy and digital image reading. An addition of intraocular pressure test does not change sensitivity (35.6%) and specificity (94.2%).


CONCLUSIONS
This study indicates that evaluations of cup-to-disc ratio and visual field, using telemedicine-friendly devices, are most useful tools in screening for glaucoma. When used together these devices may be an alternative for conventional glaucoma screenings.
Kumar
Sajeesh
S
Centre of Excellence in e-Medicine, University of Western Australia, Nedlands, Western Australia, Australia. sajeesh@cyllene.uwa.edu.au
Giubilato
Antonio
A
Morgan
William
W
Jitskaia
Ludmila
L
Barry
Chris
C
Bulsara
Max
M
Constable
Ian J
IJ
Yogesan
Kanagasingam
K
D000368:Aged; D005260:Female; D005901:Glaucoma / Q000175:diagnosis*; D006801:Humans; D007429:Intraocular Pressure; D008297:Male; D008875:Middle Aged; D009887:Ophthalmoscopy; D009898:Optic Disk / Q000473:pathology; D009901:Optic Nerve Diseases / Q000175:diagnosis; D012424:Rural Population; D012680:Sensitivity and Specificity; D017216:Telemedicine / Q000295:instrumentation*; D014065:Tonometry, Ocular; D014786:Vision Disorders / Q000175:diagnosis; D015351:Vision Screening / Q000379:methods*; D058609:Visual Field Tests; D014794:Visual Fields