Risk of Missed Diagnosis of Primary Open-Angle Glaucoma by Eye Care Providers.

IF 1.2 Q3 OPHTHALMOLOGY
Azadeh Doozandeh, Shahin Yazdani, Mohammad Pakravan, Zohreh Ghasemi, Kiana Hassanpour, Mehdi Hatami, Iman Ansari
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Abstract

Purpose: To evaluate the efficacy of opportunistic case finding in glaucoma detection and to determine factors associated with failure of glaucoma detection by eye health providers.

Methods: This study was conducted on 154 new definite primary open-angle glaucoma (POAG) patients presenting to our glaucoma clinic. A questionnaire was prepared to determine if these subjects had sought eye care up to 12 months before presentation. The type of eye care provider and the principal reason for the visit were probed. The primary outcome measure was the frequency of a correct glaucoma diagnosis in their index visit. The secondary outcomes were factors associated with missed POAG diagnosis.

Results: The great majority of study subjects (132 cases, 85.7%) had sought at least one ocular examination within 1 year before presentation. Among these patients, 73 cases (55.3%) had remained undiagnosed after the examination. Among the probed variables, age, gender, visual acuity, visual field defects, intraocular pressure, cup/disc ratio, nerve fiber layer thickness of the worse eye at presentation, and family history of glaucoma were comparable between correctly diagnosed and missed POAGs. The only factors significantly associated with missed POAG diagnosis were lack of significant refractive errors and visiting an optometrist rather than an ophthalmologist.

Conclusions: The efficacy of opportunistic case finding for POAG seems to be less than ideal in our settings. Lack of a significant refractive error and visiting an optometrist rather than an ophthalmologist were associated with a missed diagnosis of POAG. These observations reflect the need to adopt policies to improve glaucoma screening by eye care providers.

眼科护理人员对原发性开角型青光眼的漏诊风险。
目的:评价机会病例发现在青光眼检测中的效果,并确定眼科保健提供者青光眼检测失败的相关因素。方法:对154例原发性开角型青光眼(POAG)患者进行研究。准备了一份调查问卷,以确定这些受试者在就诊前12个月是否接受过眼部护理。调查了眼科保健提供者的类型和就诊的主要原因。主要结果测量是在他们的指数访问中正确诊断青光眼的频率。次要结局是与POAG漏诊相关的因素。结果:绝大多数研究对象(132例,85.7%)在就诊前1年内至少做过一次眼科检查。其中73例(55.3%)检查后仍未确诊。在调查的变量中,年龄、性别、视力、视野缺损、眼压、杯盘比、发病时最差眼的神经纤维层厚度、青光眼家族史在正确诊断和漏诊POAGs之间具有可比性。与POAG漏诊显著相关的唯一因素是没有明显的屈光不正和去看验光师而不是眼科医生。结论:在我们的环境中,机会性病例发现对POAG的疗效似乎不太理想。没有明显的屈光不正和去看验光师而不是眼科医生与POAG的漏诊相关。这些观察结果反映了需要采取政策来改善眼科保健提供者的青光眼筛查。
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来源期刊
CiteScore
2.50
自引率
6.70%
发文量
45
审稿时长
8 weeks
期刊介绍: Peer Review under the responsibility of Iranian Society of Ophthalmology Journal of Current Ophthalmology, the official publication of the Iranian Society of Ophthalmology, is a peer-reviewed, open-access, scientific journal that welcomes high quality original articles related to vision science and all fields of ophthalmology. Journal of Current Ophthalmology is the continuum of Iranian Journal of Ophthalmology published since 1969.
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