Purpose: With the current specific health screening, the fundus examination is performed only for a very limited number of people having multiple risk factors for specific lifestyle diseases. Thus, for the purpose of early detection of eye disorders, primarily glaucoma, we conducted adult ophthalmological screenings that combined frequency doubling technology (FDT) as a simple visual field examination with the conventional fundus examination. Herein, we report the screening performance of the new procedures for the identification and diagnosis of eye diseases.
Subjects and methods: In Tōgane-city, we conducted personal interviews, fundus examinations, and FDT for 4,114 individuals who were in the age group of 40-74 years and underwent specific medical examinations from 2015 to 2017. For those who required detailed examinations, medical letters were issued to request institutions to provide us with the data from detailed examinations. The primary screening results and the detailed examination data were simultaneously analyzed from multiple perspectives.
Results: Of a total of 4,114 subjects who underwent the adult ophthalmological screening, 1,411 (31%) were required to undergo the detailed examinations. We obtained the results of detailed examinations for 1,112 of 1,411 subjects examined. Of these 1,112 subjects, 164 were found to have no abnormalities, whereas the remaining 948 subjects had some abnormality. The specific abnormalities detected in the detailed examination were as follows: hypertensive retinopathy (by Scheie H's Classification) in 2, diabetic retinopathy (by Davis's Classification) in 22, glaucoma-related diseases in 343, fundus hemorrhage in 50, retina-related symptoms in 168, cataract in 488, vitreous-related diseases in 28; 47 were found to have other diseases including intracranial diseases. The screening procedure combining the conventional fundus examination and the easily implementable FDT gave a better positive prediction rate and a lower false-positive rate for glaucoma compared with the respective rates with the fundus examination alone.
Conclusions: Our results indicate that a large number of individuals with various early-stage eye diseases are left undetected in the current specific health screening. Because some cases of glaucoma and cataracts remained undetected as they did not undergo fundus examinations for a long period, amendments to the current law are desirable to make fundus examinations more readily accessible. The addition of FDT to the regular health screening should also be discussed as FDT allowed for identification of eye diseases that could not be detected with the fundus examination alone.
Nippon Ganka Gakkai Zasshi (J Jpn Ophthalmol Soc) 124: 307-316, 2020.