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Predictive value of screening tests for sight-threatening eye disease in a UK population

Lawrenson, J. ORCID: 0000-0002-2031-6390, Fidalgo, B., Dabasia, P. , Jindal, A., Edgar, D. F ORCID: 0000-0001-9004-264X, Ctori, I. ORCID: 0000-0003-1523-4996 & Peto, T. (2019). Predictive value of screening tests for sight-threatening eye disease in a UK population. Acta Ophthalmologica, 99(3), ISSN 1755-375X doi: 10.1111/j.1755-3768.2019.5092

Abstract

Background/Aims
To determine the performance of combinations of structural and functional screening tests in detecting sight-threatening eye disease in a cohort of elderly subjects recruited from primary care

Methods
505 subjects ≥ 60 years underwent: Frequency Doubling Technology (FDT) perimetry; iVue OCT (iWellness® and peripapillary retinal nerve fibre layer (RNFL) scans); IOP with the Ocular Response Analyzer (ORA), all performed by an ophthalmic technician. The reference standard was a full ophthalmic examination by an experienced clinician who was masked to the index test results. Subjects were classified as presence or absence of sight-threatening eye disease (clinically significant cataract, primary open angle glaucoma, intermediate or advanced AMD and significant diabetic retinopathy). Univariate and multivariate logistic regression was used to determine the association between abnormal screening test results and the presence of sight-threatening eye disease.

Results
171 subjects (33.8%) had one or more sight-threatening eye disease(s). The multivariate analysis found significant associations with any of the target conditions for visual acuity < 6/12, an abnormal FDT and peripapillary RNFL thickness outside the 99% normal limit. The sensitivity of this optimised screening panel was 61.3% (95% CI 53.5-68.7); specificity 78.8% (CI 74.0-83.1), positive predictive value 59.5% (CI 53.7-65.2) and an overall diagnostic accuracy of 72.9% (CI 68.8-76.8).

Conclusion
A subset of screening tests may provide an accurate and efficient means of population screening for significant eye disease in the elderly. This study provides useful preliminary data to inform the development of further larger, multicentre screening studies to validate this screening panel.

Publication Type: Conference or Workshop Item (Other)
Additional Information: This abstract Lawrenson, J. , Fidalgo, B., Dabasia, P., Jindal, A., Edgar, D. F , Ctori, I. and Peto, T. (2019). Predictive value of screening tests for sight-threatening eye disease in a UK population. Acta Ophthalmologica, 99(3), p. 343 has been published in final form at https://doi.org/10.1111/j.1755-3768.2019.5092. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions. This article may not be enhanced, enriched or otherwise transformed into a derivative work, without express permission from Wiley or by statutory rights under applicable legislation. Copyright notices must not be removed, obscured or modified. The article must be linked to Wiley’s version of record on Wiley Online Library and any embedding, framing or otherwise making available the article or pages thereof by third parties from platforms, services and websites other than Wiley Online Library must be prohibited.
Subjects: R Medicine > RE Ophthalmology
Departments: School of Health & Psychological Sciences > Optometry & Visual Sciences
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