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Population and high-risk group screening for glaucoma: the Los Angeles Latino Eye Study
To evaluate the ability of various screening tests, both individually and in combination, to detect glaucoma in the general Latino population and high-risk subgroups. The Los Angeles Latino Eye Study is a population-based study of eye disease in Latinos 40 years of age and older. Participants (n = 6...
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| Published in: | Investigative ophthalmology & visual science 2011-08, Vol.52 (9), p.6257-6264 |
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| container_end_page | 6264 |
| container_issue | 9 |
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| container_title | Investigative ophthalmology & visual science |
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| creator | Francis, Brian A Varma, Rohit Vigen, Cheryl Lai, Mei-Ying Winarko, Jonathan Nguyen, Betsy Azen, Stanley |
| description | To evaluate the ability of various screening tests, both individually and in combination, to detect glaucoma in the general Latino population and high-risk subgroups.
The Los Angeles Latino Eye Study is a population-based study of eye disease in Latinos 40 years of age and older. Participants (n = 6082) underwent Humphrey visual field testing (HVF), frequency doubling technology (FDT) perimetry, measurement of intraocular pressure (IOP) and central corneal thickness (CCT), and independent assessment of optic nerve vertical cup disc (C/D) ratio. Screening parameters were evaluated for three definitions of glaucoma based on optic disc, visual field, and a combination of both. Analyses were also conducted for high-risk subgroups (family history of glaucoma, diabetes mellitus, and age ≥65 years). Sensitivity, specificity, and receiver operating characteristic curves were calculated for those continuous parameters independently associated with glaucoma. Classification and regression tree (CART) analysis was used to develop a multivariate algorithm for glaucoma screening.
Preset cutoffs for screening parameters yielded a generally poor balance of sensitivity and specificity (sensitivity/specificity for IOP ≥21 mm Hg and C/D ≥0.8 was 0.24/0.97 and 0.60/0.98, respectively). Assessment of high-risk subgroups did not improve the sensitivity/specificity of individual screening parameters. A CART analysis using multiple screening parameters-C/D, HVF, and IOP-substantially improved the balance of sensitivity and specificity (sensitivity/specificity 0.92/0.92).
No single screening parameter is useful for glaucoma screening. However, a combination of vertical C/D ratio, HVF, and IOP provides the best balance of sensitivity/specificity and is likely to provide the highest yield in glaucoma screening programs. |
| doi_str_mv | 10.1167/iovs.09-5126 |
| format | article |
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The Los Angeles Latino Eye Study is a population-based study of eye disease in Latinos 40 years of age and older. Participants (n = 6082) underwent Humphrey visual field testing (HVF), frequency doubling technology (FDT) perimetry, measurement of intraocular pressure (IOP) and central corneal thickness (CCT), and independent assessment of optic nerve vertical cup disc (C/D) ratio. Screening parameters were evaluated for three definitions of glaucoma based on optic disc, visual field, and a combination of both. Analyses were also conducted for high-risk subgroups (family history of glaucoma, diabetes mellitus, and age ≥65 years). Sensitivity, specificity, and receiver operating characteristic curves were calculated for those continuous parameters independently associated with glaucoma. Classification and regression tree (CART) analysis was used to develop a multivariate algorithm for glaucoma screening.
Preset cutoffs for screening parameters yielded a generally poor balance of sensitivity and specificity (sensitivity/specificity for IOP ≥21 mm Hg and C/D ≥0.8 was 0.24/0.97 and 0.60/0.98, respectively). Assessment of high-risk subgroups did not improve the sensitivity/specificity of individual screening parameters. A CART analysis using multiple screening parameters-C/D, HVF, and IOP-substantially improved the balance of sensitivity and specificity (sensitivity/specificity 0.92/0.92).
No single screening parameter is useful for glaucoma screening. However, a combination of vertical C/D ratio, HVF, and IOP provides the best balance of sensitivity/specificity and is likely to provide the highest yield in glaucoma screening programs.</description><identifier>ISSN: 1552-5783</identifier><identifier>ISSN: 0146-0404</identifier><identifier>EISSN: 1552-5783</identifier><identifier>DOI: 10.1167/iovs.09-5126</identifier><identifier>PMID: 21245400</identifier><language>eng</language><publisher>United States: Association for Research in Vision and Ophthalmology, Inc</publisher><subject>Aged ; Area Under Curve ; Female ; Glaucoma, Open-Angle - diagnosis ; Glaucoma, Open-Angle - epidemiology ; Hispanic Americans - statistics & numerical data ; Humans ; Intraocular Pressure ; Los Angeles - epidemiology ; Male ; Optic Nerve Diseases - diagnosis ; Optic Nerve Diseases - epidemiology ; Reproducibility of Results ; Risk Assessment ; ROC Curve ; Sensitivity and Specificity ; Vision Disorders - diagnosis ; Vision Disorders - epidemiology ; Vision Screening - methods ; Visual Field Tests ; Visual Fields</subject><ispartof>Investigative ophthalmology & visual science, 2011-08, Vol.52 (9), p.6257-6264</ispartof><rights>Copyright © Association for Research in Vision and Ophthalmology 2011</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c383t-7f79a545786692c5e20d8cebc026d9561bc3c737f1b6051094774b445fc96d8c3</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3175989/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3175989/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,315,733,786,790,891,27957,27958,53827,53829</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21245400$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Francis, Brian A</creatorcontrib><creatorcontrib>Varma, Rohit</creatorcontrib><creatorcontrib>Vigen, Cheryl</creatorcontrib><creatorcontrib>Lai, Mei-Ying</creatorcontrib><creatorcontrib>Winarko, Jonathan</creatorcontrib><creatorcontrib>Nguyen, Betsy</creatorcontrib><creatorcontrib>Azen, Stanley</creatorcontrib><creatorcontrib>Los Angeles Latino Eye Study Group</creatorcontrib><title>Population and high-risk group screening for glaucoma: the Los Angeles Latino Eye Study</title><title>Investigative ophthalmology & visual science</title><addtitle>Invest Ophthalmol Vis Sci</addtitle><description>To evaluate the ability of various screening tests, both individually and in combination, to detect glaucoma in the general Latino population and high-risk subgroups.
The Los Angeles Latino Eye Study is a population-based study of eye disease in Latinos 40 years of age and older. Participants (n = 6082) underwent Humphrey visual field testing (HVF), frequency doubling technology (FDT) perimetry, measurement of intraocular pressure (IOP) and central corneal thickness (CCT), and independent assessment of optic nerve vertical cup disc (C/D) ratio. Screening parameters were evaluated for three definitions of glaucoma based on optic disc, visual field, and a combination of both. Analyses were also conducted for high-risk subgroups (family history of glaucoma, diabetes mellitus, and age ≥65 years). Sensitivity, specificity, and receiver operating characteristic curves were calculated for those continuous parameters independently associated with glaucoma. Classification and regression tree (CART) analysis was used to develop a multivariate algorithm for glaucoma screening.
Preset cutoffs for screening parameters yielded a generally poor balance of sensitivity and specificity (sensitivity/specificity for IOP ≥21 mm Hg and C/D ≥0.8 was 0.24/0.97 and 0.60/0.98, respectively). Assessment of high-risk subgroups did not improve the sensitivity/specificity of individual screening parameters. A CART analysis using multiple screening parameters-C/D, HVF, and IOP-substantially improved the balance of sensitivity and specificity (sensitivity/specificity 0.92/0.92).
No single screening parameter is useful for glaucoma screening. However, a combination of vertical C/D ratio, HVF, and IOP provides the best balance of sensitivity/specificity and is likely to provide the highest yield in glaucoma screening programs.</description><subject>Aged</subject><subject>Area Under Curve</subject><subject>Female</subject><subject>Glaucoma, Open-Angle - diagnosis</subject><subject>Glaucoma, Open-Angle - epidemiology</subject><subject>Hispanic Americans - statistics & numerical data</subject><subject>Humans</subject><subject>Intraocular Pressure</subject><subject>Los Angeles - epidemiology</subject><subject>Male</subject><subject>Optic Nerve Diseases - diagnosis</subject><subject>Optic Nerve Diseases - epidemiology</subject><subject>Reproducibility of Results</subject><subject>Risk Assessment</subject><subject>ROC Curve</subject><subject>Sensitivity and Specificity</subject><subject>Vision Disorders - diagnosis</subject><subject>Vision Disorders - epidemiology</subject><subject>Vision Screening - methods</subject><subject>Visual Field Tests</subject><subject>Visual Fields</subject><issn>1552-5783</issn><issn>0146-0404</issn><issn>1552-5783</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><recordid>eNpVkF1LwzAUhoMobk7vvJb8ADuTtGkaL4Qx5gcUFFS8DGmattEuKUk72L-3Yzr06hw473nO4QHgEqM5xim7MW4T5ohHFJP0CEwxpSSiLIuP__QTcBbCJ0IEY4JOwYRgktAEoSn4eHHd0MreOAulLWFj6ibyJnzB2ruhg0F5ra2xNaych3UrB-XW8hb2jYa5C3Bha93qAPMRYR1cbTV87Ydyew5OKtkGffFTZ-D9fvW2fIzy54en5SKPVJzFfcQqxiVNxh_TlBNFNUFlpnShEElLTlNcqFixmFW4SBHFiCeMJUWS0ErxdEzGM3C353ZDsdal0rb3shWdN2vpt8JJI_5PrGlE7TYixozyjI-A6z1AeReC19VhFyOxEyx2ggXiYid4jF_9vXcI_xqNvwFGt3hN</recordid><startdate>20110805</startdate><enddate>20110805</enddate><creator>Francis, Brian A</creator><creator>Varma, Rohit</creator><creator>Vigen, Cheryl</creator><creator>Lai, Mei-Ying</creator><creator>Winarko, Jonathan</creator><creator>Nguyen, Betsy</creator><creator>Azen, Stanley</creator><general>Association for Research in Vision and Ophthalmology, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>5PM</scope></search><sort><creationdate>20110805</creationdate><title>Population and high-risk group screening for glaucoma: the Los Angeles Latino Eye Study</title><author>Francis, Brian A ; Varma, Rohit ; Vigen, Cheryl ; Lai, Mei-Ying ; Winarko, Jonathan ; Nguyen, Betsy ; Azen, Stanley</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c383t-7f79a545786692c5e20d8cebc026d9561bc3c737f1b6051094774b445fc96d8c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Aged</topic><topic>Area Under Curve</topic><topic>Female</topic><topic>Glaucoma, Open-Angle - diagnosis</topic><topic>Glaucoma, Open-Angle - epidemiology</topic><topic>Hispanic Americans - statistics & numerical data</topic><topic>Humans</topic><topic>Intraocular Pressure</topic><topic>Los Angeles - epidemiology</topic><topic>Male</topic><topic>Optic Nerve Diseases - diagnosis</topic><topic>Optic Nerve Diseases - epidemiology</topic><topic>Reproducibility of Results</topic><topic>Risk Assessment</topic><topic>ROC Curve</topic><topic>Sensitivity and Specificity</topic><topic>Vision Disorders - diagnosis</topic><topic>Vision Disorders - epidemiology</topic><topic>Vision Screening - methods</topic><topic>Visual Field Tests</topic><topic>Visual Fields</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Francis, Brian A</creatorcontrib><creatorcontrib>Varma, Rohit</creatorcontrib><creatorcontrib>Vigen, Cheryl</creatorcontrib><creatorcontrib>Lai, Mei-Ying</creatorcontrib><creatorcontrib>Winarko, Jonathan</creatorcontrib><creatorcontrib>Nguyen, Betsy</creatorcontrib><creatorcontrib>Azen, Stanley</creatorcontrib><creatorcontrib>Los Angeles Latino Eye Study Group</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Investigative ophthalmology & visual science</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Francis, Brian A</au><au>Varma, Rohit</au><au>Vigen, Cheryl</au><au>Lai, Mei-Ying</au><au>Winarko, Jonathan</au><au>Nguyen, Betsy</au><au>Azen, Stanley</au><aucorp>Los Angeles Latino Eye Study Group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Population and high-risk group screening for glaucoma: the Los Angeles Latino Eye Study</atitle><jtitle>Investigative ophthalmology & visual science</jtitle><addtitle>Invest Ophthalmol Vis Sci</addtitle><date>2011-08-05</date><risdate>2011</risdate><volume>52</volume><issue>9</issue><spage>6257</spage><epage>6264</epage><pages>6257-6264</pages><issn>1552-5783</issn><issn>0146-0404</issn><eissn>1552-5783</eissn><notes>See the Appendix for the members of the Los Angeles Latino Eye Study Group.</notes><abstract>To evaluate the ability of various screening tests, both individually and in combination, to detect glaucoma in the general Latino population and high-risk subgroups.
The Los Angeles Latino Eye Study is a population-based study of eye disease in Latinos 40 years of age and older. Participants (n = 6082) underwent Humphrey visual field testing (HVF), frequency doubling technology (FDT) perimetry, measurement of intraocular pressure (IOP) and central corneal thickness (CCT), and independent assessment of optic nerve vertical cup disc (C/D) ratio. Screening parameters were evaluated for three definitions of glaucoma based on optic disc, visual field, and a combination of both. Analyses were also conducted for high-risk subgroups (family history of glaucoma, diabetes mellitus, and age ≥65 years). Sensitivity, specificity, and receiver operating characteristic curves were calculated for those continuous parameters independently associated with glaucoma. Classification and regression tree (CART) analysis was used to develop a multivariate algorithm for glaucoma screening.
Preset cutoffs for screening parameters yielded a generally poor balance of sensitivity and specificity (sensitivity/specificity for IOP ≥21 mm Hg and C/D ≥0.8 was 0.24/0.97 and 0.60/0.98, respectively). Assessment of high-risk subgroups did not improve the sensitivity/specificity of individual screening parameters. A CART analysis using multiple screening parameters-C/D, HVF, and IOP-substantially improved the balance of sensitivity and specificity (sensitivity/specificity 0.92/0.92).
No single screening parameter is useful for glaucoma screening. However, a combination of vertical C/D ratio, HVF, and IOP provides the best balance of sensitivity/specificity and is likely to provide the highest yield in glaucoma screening programs.</abstract><cop>United States</cop><pub>Association for Research in Vision and Ophthalmology, Inc</pub><pmid>21245400</pmid><doi>10.1167/iovs.09-5126</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Aged Area Under Curve Female Glaucoma, Open-Angle - diagnosis Glaucoma, Open-Angle - epidemiology Hispanic Americans - statistics & numerical data Humans Intraocular Pressure Los Angeles - epidemiology Male Optic Nerve Diseases - diagnosis Optic Nerve Diseases - epidemiology Reproducibility of Results Risk Assessment ROC Curve Sensitivity and Specificity Vision Disorders - diagnosis Vision Disorders - epidemiology Vision Screening - methods Visual Field Tests Visual Fields |
| title | Population and high-risk group screening for glaucoma: the Los Angeles Latino Eye Study |
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