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Development of a new algorithm based on FDT Matrix perimetry and SD-OCT to improve early glaucoma detection in primary care
摘要： Purpose: The purpose of this study was to develop an objective algorithm to discriminate the earliest stages of glaucoma using frequency doubling technology (FDT) Matrix perimetry and spectral domain-optical coherence tomography (OCT) technology to improve primary care detection. Materials and methods: Three hundred six eyes (mean age 58.67±15.12) from 161 patients were included and classified in the following three groups: 101 nonglaucoma (GI-NG), 100 glaucoma suspect (GII-SG), and 105 open-angle glaucoma (GIII-OAG). All participants underwent a visual field exploration using the Humphrey Matrix visual field instrument and retinal nerve fiber layer evaluation using the Topcon 3D OCT-2000. Pattern deviation plot was divided into 19 areas and five aggrupation or quadrants and ranked with a value between 0 and 4 according to its likelihood of normality, and differences among three groups were analyzed. Principal component analysis (PCA) was also used to extract the most notable features of FDT and OCT, and a logistic regression analysis was applied to obtain the classification rules. Results: Only area numbers 7 and 12 and the central zone of FDT Matrix showed statistical differences (P<0.05) between GI-NG and GII-SG. The classification rules were estimated by the four PCA obtained from FDT Matrix and 3D OCT-2000 in a separate and combined use. Area under the receiver operating characteristic curve was 78.88% with FDT-PCA, 82.09% with OCT-PCA, and 94.27% with combined use of FDT and OCT-PCA to discriminate GI-NG and GII-SG. Conclusion: The predictive rules based on FDT-PCA or OCT-PCA provide a high sensitivity and specificity to detect the earliest stages of glaucoma and even better in combined use. These predictive rules may help the future development of software for FDT Matrix perimetry and 3D OCT-2000, which will greatly improve their diagnostic ability, making them useful in daily practice in a primary care setting.
关键词： 3D OCT-2000,PCA,glaucoma,primary care,FDT Matrix
更新于2025-09-23 15:23:52
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Assessment of diabetic teleretinal imaging program at the Portland Department of Veterans Affairs Medical Center
摘要： We conducted a retrospective chart review of 200 diabetic patients who had teleretinal imaging performed between January 1, 2010, and January 1, 2011, at Portland Department of Veterans Affairs (VA) Medical Center outpatient clinics to assess the effectiveness of the diabetic teleretinal imaging program. Twenty patients (10%) had diabetic retinopathy. Ninety percent of the available teleretinal imaging studies were of adequate quality for interpretation. In accordance with local VA policy at that time, all teleretinal imaging patients should have been referred for a dilated retinal examination the following year. Image readers referred 97.5% of the patients to eye clinics for subsequent eye examinations, but the imagers scheduled appointments for only 80% of these patients. The redundancy rate, i.e., patients who had an eye examination within the past 6 mo, was 11%; the duplicate recall rate, i.e., patients who had a second teleretinal imaging performed within 1 yr of the eye examination, was 37%. Rates of timely diabetic eye examinations at clinics with teleretinal imaging programs, particularly when teleretinal imaging and eye clinics were colocated at the same community-based outpatient clinic, were higher than at those without a teleretinal imaging program. We concluded that the Portland VA Medical Center's teleretinal imaging program was successful in increasing the screening rate for diabetic retinopathy.
关键词： teleretinal imaging program,diabetes mellitus,dilated eye examination,diabetic retinal examination,primary care,diabetic retinopathy,outpatient clinic,screening,teleretinal imaging,telehealth
更新于2025-09-23 15:22:29