Predictive value of Frequency Doubling Technology perimetry for detecting glaucoma in a developing country

Steven L. Mansberger, Chris A. Johnson, George A. Cioffi, Dongseok Choi, S. R. Krishnadas, M. Srinivasan, V. Balamurugan, Usha Kim, Scott D. Smith, John H. Wilkins, David C. Gritz

Research output: Contribution to journalArticle

30 Citations (Scopus)

Abstract

Purpose: To determine the feasibility and diagnostic precision of Frequency Doubling Technology (FDT) perimetry as a method to detect glaucoma in rural villages of a developing country. Design: Cross-sectional study. Methods: Testing included FDT perimetry (C-20-5 screening protocol), tonometry, anterior segment biomicroscopy, and dilated ophthalmoscopy in 296 rural, non-English speaking residents of Southern India over 35 years old. Participants repeated the FDT if they had a location with reduced sensitivity or an unreliable result. We defined an abnormal FDT as one location of reduced sensitivity present on both the initial and repeat examination. We determined the diagnostic precision of FDT separately for a glaucomatous optic disc, a cup to disc ratio (C/D) ≥ 0.7, and a C/D ≥ 0.8. Results: Ninety-three percent of subjects were able to complete the test satisfactorily. With repeat FDT testing, 37% of eyes with abnormal FDT results subsequently converted to normal and 67% of eyes with unreliable results subsequently became reliable. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy for a glaucomatous optic disc were 7%, 87%, 13%, 76%, and 69%, respectively; for a C/D ≥ 0.7, they were 0%, 87%, 0%, 91%, and 81%, respectively; and for a C/D ≥ 0.8, they were 0%, 87%, 0%, 99%, and 87%, respectively. Conclusion: Clinicians can use FDT perimetry to rapidly screen for glaucoma in rural villages of a developing country. FDT testing had high specificity and negative predictive value, but low sensitivity and positive predictive value. The low sensitivity suggests that FDT has limited applicability as the sole test for glaucoma screening in this population. Repeat testing of FDT results that are unreliable or suspected of being abnormal is beneficial for this screening procedure.

Original languageEnglish (US)
Pages (from-to)128-134
Number of pages7
JournalJournal of Glaucoma
Volume14
Issue number2
DOIs
StatePublished - Apr 2005
Externally publishedYes

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Visual Field Tests
Glaucoma
Developing Countries
Technology
Optic Disk
Ophthalmoscopy
Manometry
India
Cross-Sectional Studies

Keywords

  • Developing country
  • Glaucoma
  • India
  • Optic disc
  • Perimetry
  • Screening

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Mansberger, S. L., Johnson, C. A., Cioffi, G. A., Choi, D., Krishnadas, S. R., Srinivasan, M., ... Gritz, D. C. (2005). Predictive value of Frequency Doubling Technology perimetry for detecting glaucoma in a developing country. Journal of Glaucoma, 14(2), 128-134. https://doi.org/10.1097/01.ijg.0000151883.07232.54

Predictive value of Frequency Doubling Technology perimetry for detecting glaucoma in a developing country. / Mansberger, Steven L.; Johnson, Chris A.; Cioffi, George A.; Choi, Dongseok; Krishnadas, S. R.; Srinivasan, M.; Balamurugan, V.; Kim, Usha; Smith, Scott D.; Wilkins, John H.; Gritz, David C.

In: Journal of Glaucoma, Vol. 14, No. 2, 04.2005, p. 128-134.

Research output: Contribution to journalArticle

Mansberger, SL, Johnson, CA, Cioffi, GA, Choi, D, Krishnadas, SR, Srinivasan, M, Balamurugan, V, Kim, U, Smith, SD, Wilkins, JH & Gritz, DC 2005, 'Predictive value of Frequency Doubling Technology perimetry for detecting glaucoma in a developing country', Journal of Glaucoma, vol. 14, no. 2, pp. 128-134. https://doi.org/10.1097/01.ijg.0000151883.07232.54
Mansberger, Steven L. ; Johnson, Chris A. ; Cioffi, George A. ; Choi, Dongseok ; Krishnadas, S. R. ; Srinivasan, M. ; Balamurugan, V. ; Kim, Usha ; Smith, Scott D. ; Wilkins, John H. ; Gritz, David C. / Predictive value of Frequency Doubling Technology perimetry for detecting glaucoma in a developing country. In: Journal of Glaucoma. 2005 ; Vol. 14, No. 2. pp. 128-134.
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abstract = "Purpose: To determine the feasibility and diagnostic precision of Frequency Doubling Technology (FDT) perimetry as a method to detect glaucoma in rural villages of a developing country. Design: Cross-sectional study. Methods: Testing included FDT perimetry (C-20-5 screening protocol), tonometry, anterior segment biomicroscopy, and dilated ophthalmoscopy in 296 rural, non-English speaking residents of Southern India over 35 years old. Participants repeated the FDT if they had a location with reduced sensitivity or an unreliable result. We defined an abnormal FDT as one location of reduced sensitivity present on both the initial and repeat examination. We determined the diagnostic precision of FDT separately for a glaucomatous optic disc, a cup to disc ratio (C/D) ≥ 0.7, and a C/D ≥ 0.8. Results: Ninety-three percent of subjects were able to complete the test satisfactorily. With repeat FDT testing, 37{\%} of eyes with abnormal FDT results subsequently converted to normal and 67{\%} of eyes with unreliable results subsequently became reliable. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy for a glaucomatous optic disc were 7{\%}, 87{\%}, 13{\%}, 76{\%}, and 69{\%}, respectively; for a C/D ≥ 0.7, they were 0{\%}, 87{\%}, 0{\%}, 91{\%}, and 81{\%}, respectively; and for a C/D ≥ 0.8, they were 0{\%}, 87{\%}, 0{\%}, 99{\%}, and 87{\%}, respectively. Conclusion: Clinicians can use FDT perimetry to rapidly screen for glaucoma in rural villages of a developing country. FDT testing had high specificity and negative predictive value, but low sensitivity and positive predictive value. The low sensitivity suggests that FDT has limited applicability as the sole test for glaucoma screening in this population. Repeat testing of FDT results that are unreliable or suspected of being abnormal is beneficial for this screening procedure.",
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AU - Mansberger, Steven L.

AU - Johnson, Chris A.

AU - Cioffi, George A.

AU - Choi, Dongseok

AU - Krishnadas, S. R.

AU - Srinivasan, M.

AU - Balamurugan, V.

AU - Kim, Usha

AU - Smith, Scott D.

AU - Wilkins, John H.

AU - Gritz, David C.

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N2 - Purpose: To determine the feasibility and diagnostic precision of Frequency Doubling Technology (FDT) perimetry as a method to detect glaucoma in rural villages of a developing country. Design: Cross-sectional study. Methods: Testing included FDT perimetry (C-20-5 screening protocol), tonometry, anterior segment biomicroscopy, and dilated ophthalmoscopy in 296 rural, non-English speaking residents of Southern India over 35 years old. Participants repeated the FDT if they had a location with reduced sensitivity or an unreliable result. We defined an abnormal FDT as one location of reduced sensitivity present on both the initial and repeat examination. We determined the diagnostic precision of FDT separately for a glaucomatous optic disc, a cup to disc ratio (C/D) ≥ 0.7, and a C/D ≥ 0.8. Results: Ninety-three percent of subjects were able to complete the test satisfactorily. With repeat FDT testing, 37% of eyes with abnormal FDT results subsequently converted to normal and 67% of eyes with unreliable results subsequently became reliable. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy for a glaucomatous optic disc were 7%, 87%, 13%, 76%, and 69%, respectively; for a C/D ≥ 0.7, they were 0%, 87%, 0%, 91%, and 81%, respectively; and for a C/D ≥ 0.8, they were 0%, 87%, 0%, 99%, and 87%, respectively. Conclusion: Clinicians can use FDT perimetry to rapidly screen for glaucoma in rural villages of a developing country. FDT testing had high specificity and negative predictive value, but low sensitivity and positive predictive value. The low sensitivity suggests that FDT has limited applicability as the sole test for glaucoma screening in this population. Repeat testing of FDT results that are unreliable or suspected of being abnormal is beneficial for this screening procedure.

AB - Purpose: To determine the feasibility and diagnostic precision of Frequency Doubling Technology (FDT) perimetry as a method to detect glaucoma in rural villages of a developing country. Design: Cross-sectional study. Methods: Testing included FDT perimetry (C-20-5 screening protocol), tonometry, anterior segment biomicroscopy, and dilated ophthalmoscopy in 296 rural, non-English speaking residents of Southern India over 35 years old. Participants repeated the FDT if they had a location with reduced sensitivity or an unreliable result. We defined an abnormal FDT as one location of reduced sensitivity present on both the initial and repeat examination. We determined the diagnostic precision of FDT separately for a glaucomatous optic disc, a cup to disc ratio (C/D) ≥ 0.7, and a C/D ≥ 0.8. Results: Ninety-three percent of subjects were able to complete the test satisfactorily. With repeat FDT testing, 37% of eyes with abnormal FDT results subsequently converted to normal and 67% of eyes with unreliable results subsequently became reliable. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy for a glaucomatous optic disc were 7%, 87%, 13%, 76%, and 69%, respectively; for a C/D ≥ 0.7, they were 0%, 87%, 0%, 91%, and 81%, respectively; and for a C/D ≥ 0.8, they were 0%, 87%, 0%, 99%, and 87%, respectively. Conclusion: Clinicians can use FDT perimetry to rapidly screen for glaucoma in rural villages of a developing country. FDT testing had high specificity and negative predictive value, but low sensitivity and positive predictive value. The low sensitivity suggests that FDT has limited applicability as the sole test for glaucoma screening in this population. Repeat testing of FDT results that are unreliable or suspected of being abnormal is beneficial for this screening procedure.

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KW - India

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KW - Perimetry

KW - Screening

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