142nd APHA Annual Meeting and Exposition

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Population Based Visual Field Screening in Nepal to Detect Glaucoma and Diabetic Retinopathy

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Tuesday, November 18, 2014 : 1:10 PM - 1:30 PM

Chris A. Johnson, PhD, DSc , Department of Ophthalmology and Visual Sciences, School of Medicine, University of Iowa, Iowa City, IA
Suman Thapa, MD, PhD , Head, Nepal Glaucoma Eye Clinic, Tilganga Institute of Ophthalmology, Kathmandu, Nepal, Nepal
Alan L. Robin, MD , Department of Ophthalmology, School of Medicine, University of Maryland and Johns Hopkins University, Baltimore, MD
Audio (mp3) recording Recorded Presentation (mp4)
Purpose: To evaluate a low cost, portable perimetry (visual field) screening device in Nepal for population based screening to detect glaucoma and diabetic retinopathy.

Methods: The iPad app Easyfield perimetry screening procedure (background luminance = 10 cd/m2, stimulus size = V [1.72 degrees], stimulus luminance = 16 dB [76 cd/m2]) was calibrated and used to test 282 eyes of 141 participants (130 healthy, 134 glaucomatous, and 18 diabetic retinopathy eyes).  Testing was performed at the standard 33 cm testing distance, and participants wore their presenting spectacles, if any. Four visual field quadrants (upper left and right and lower left and right) were tested sequentially for a total of 94 test locations).  Results were compared to findings for a traditional automated perimetry test (Humphrey Field Analyzer 24-2 SITA Standard procedure), which is currently the clinical gold standard.

Results: The number of Easyfield test locations that were missed correlated well with the mean deviation (r = 0.75) and pattern standard deviation (r = 0.59) of the Humphrey Field Analyzer. These values are slightly lower than the test-retest reproducibility of the Humphrey Field Analyzer.  Testing time for the Easyfield averaged 3 minutes and 26 seconds per eye (sd = 19 seconds).

Conclusion: The Easyfield test procedure performs well for population based screening for glaucoma and diabetic retinopathy and the location of perimetric deficits correspond to those obtained by the Humphrey Field Analyzer. This procedure should be an effective tool for screening for eye disease in populations with limited access to health care.

Learning Areas:

Basic medical science applied in public health

Learning Objectives:
Demonstrate the use of a low cost, portable visual field screening device to detect glaucoma and diabetic retinopathy in populations with limited access to health care.

Keyword(s): Community Health Programs, Health Care Access

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been the principal investigator on many federally funded clinical research grants over the past 35 years, and am considered to be a leading investigator in the development and evaluation of perimetry and visual field devices.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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