Screening Strategies and Methodologies.

IF 2 4区 医学 Q2 OPHTHALMOLOGY
Journal of Glaucoma Pub Date : 2024-08-01 Epub Date: 2024-08-19 DOI:10.1097/IJG.0000000000002426
Panagiota Founti, Kelsey Stuart, Winifred P Nolan, Anthony P Khawaja, Paul J Foster
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引用次数: 0

Abstract

Prcis: While glaucoma is a leading cause of irreversible vision loss, it presents technical challenges in the design and implementation of screening. New technologies such as PRS and AI offer potential improvements in our ability to identify people at high risk of sight loss from glaucoma and may improve the viability of screening for this important disease.

Purpose: To review the current evidence and concepts around screening for glaucoma.

Methods/results: A group of glaucoma-focused clinician scientists drew on knowledge and experience around glaucoma, its etiology, and the options for screening. Glaucoma is a chronic progressive optic neuropathy affecting around 76 million individuals worldwide and is the leading cause of irreversible blindness globally. Early stages of the disease are asymptomatic meaning a substantial proportion of cases remain undiagnosed. Early detection and timely intervention reduce the risk of glaucoma-related visual morbidity. However, imperfect tests and a relatively low prevalence currently limit the viability of population-based screening approaches. The diagnostic yield of opportunistic screening strategies, relying on the identification of disease during unrelated health care encounters, such as cataract clinics and diabetic retinopathy screening programs, focusing on older people and/or those with a family history, are hindered by a large number of false-positive and false-negative results. Polygenic risk scores (PRS) offer personalized risk assessment for adult-onset glaucoma. In addition, artificial intelligence (AI) algorithms have shown impressive performance, comparable to expert humans, in discriminating between potentially glaucomatous and non-glaucomatous eyes. These emerging technologies may offer a meaningful improvement in diagnostic yield in glaucoma screening.

Conclusions: While glaucoma is a leading cause of irreversible vision loss, it presents technical challenges in the design and implementation of screening. New technologies such as PRS and AI offer potential improvements in our ability to identify people at high risk of sight loss from glaucoma and may improve the viability of screening for this important disease.

筛选策略和方法。
Prcis:虽然青光眼是造成不可逆转的视力损失的主要原因,但在设计和实施筛查时却面临着技术挑战。PRS和人工智能等新技术为我们识别青光眼视力丧失高风险人群的能力提供了潜在的改进,并可能提高这一重要疾病筛查的可行性。目的:回顾有关青光眼筛查的现有证据和概念:一组以青光眼为重点的临床科学家借鉴了有关青光眼、其病因和筛查方案的知识和经验。青光眼是一种慢性进行性视神经病变,影响着全球约 7600 万人,是导致全球不可逆失明的主要原因。该病早期无症状,这意味着相当一部分病例仍未得到诊断。早期发现和及时干预可降低与青光眼相关的视觉发病风险。然而,目前不完善的检测方法和相对较低的发病率限制了基于人群的筛查方法的可行性。机会性筛查策略依赖于在不相关的医疗保健过程中发现疾病,如白内障门诊和糖尿病视网膜病变筛查计划,主要针对老年人和/或有家族史的人,但大量的假阳性和假阴性结果阻碍了其诊断率。多基因风险评分(PRS)可对成人型青光眼进行个性化风险评估。此外,人工智能(AI)算法在区分潜在青光眼和非青光眼方面的表现令人印象深刻,可与人类专家相媲美。这些新兴技术可显著提高青光眼筛查的诊断率:虽然青光眼是造成不可逆视力损失的主要原因,但它给筛查的设计和实施带来了技术挑战。PRS 和人工智能等新技术为我们识别青光眼高失明风险人群的能力提供了潜在的改进,并可能提高这一重要疾病筛查的可行性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of Glaucoma
Journal of Glaucoma 医学-眼科学
CiteScore
4.20
自引率
10.00%
发文量
330
审稿时长
4-8 weeks
期刊介绍: The Journal of Glaucoma is a peer reviewed journal addressing the spectrum of issues affecting definition, diagnosis, and management of glaucoma and providing a forum for lively and stimulating discussion of clinical, scientific, and socioeconomic factors affecting care of glaucoma patients.
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