The additional yield of a periodic screening programme for open-angle glaucoma: a population-based comparison of incident glaucoma cases detected in regular ophthalmic care with cases detected during screening.
OBJECTIVE
To study the additional yield of a periodic screening programme for open-angle glaucoma (OAG) by comparing, in a population-based setting, incident OAG (iOAG) cases detected in regular ophthalmic care with those detected during screening.


METHODS
Participants aged 55 and over from the population-based Rotterdam Study underwent the same ophthalmic examination at baseline (1991-3) and follow-up (1997-9), including visual field testing and simultaneous stereo optic disc photography. Of 3842 participants, 87 (2.3%) developed iOAG during a mean follow-up time of 6.5 years. Of these 87 iOAG cases, 78 (90%) were included in this study.


RESULTS
Of the 78 iOAG cases detected at follow-up, 23 (29%) had already been detected before during regular ophthalmic care. The remaining 55 (71%) undetected iOAG cases more often showed glaucomatous optic neuropathy without glaucomatous visual field loss (29 of 55 (53%)) as compared with the detected cases (four of 23 (17%); p = 0.009). Of the undetected iOAG cases, only four had developed significant visual field loss in their better eye.


CONCLUSIONS
The additional yield of a periodic OAG screening programme is lower than expected from published prevalence data. In the discussion, the authors estimate that-in a white population with a low prevalence of pseudoexfoliation-about one in 1000 screened persons could be saved from bilateral end-stage OAG.
Stoutenbeek
R
R
University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
de Voogd
S
S
Wolfs
R C W
RC
Hofman
A
A
de Jong
P T V M
PT
Jansonius
N M
NM
D000368:Aged; D002985:Clinical Protocols; D015331:Cohort Studies; D042241:Early Diagnosis; D005260:Female; D005902:Glaucoma, Open-Angle / Q000175:diagnosis* / Q000453:epidemiology; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D009887:Ophthalmoscopy / Q000379:methods; D009901:Optic Nerve Diseases / Q000175:diagnosis* / Q000453:epidemiology; D011446:Prospective Studies; D012307:Risk Factors; D019987:Persons with Visual Disabilities