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A Glaucoma Tele-screening Program Report TOSCA (Tele-Ophthalmological Services Citizen-centered Application) an EU Project
1Wegner A., 2Zahlmann G.,
1Technische Universität München, Klinikum rechts der Isar, Augenklinik (München)
2Siemens Medical Solutions (Erlangen)
Purpose: Glaucoma is the most common cause of preventable blindness in industrialised countries. About 50% of people suffering from glaucoma are not aware of their illness. A glaucoma screening tele-ohthalmological platform was developed and applied in the community.
Method: A population based glaucoma screening was done in Munich. Intraocular pressure (IOP) was measured with a Goldmann tonometer. Optic disc images were taken using Heidelberg Retinal Tomograph II (HRT). The Examinations and results were sent to a central server. 10% of the normal HRT and all abnormal and borderline underwent a second evaluation as part of a quality assurance procedure.
Results: During 6 months 1661 people were screened. 202(12%) people in the age group 20-29 years (y), 435(26%) in the age group 30-39y, 519(31%) in the age group 40-49y, 477(29%) in the age group 50-59y and 37(2%) in the age group 60-69y. According to the HRT examination 1508 (91%) people had normal optic discs. 108(6%) people had at least one borderline optic disc. 45(3%) people had at least one abnormal optic disc. 1610 (97%) people had an IOP< 21mmHg. 51 (3%) people had an IOP> 22mmHg. 4 subjects had an IOP> 22mmHg and at least one abnormal optic disc. 483 HRT examinations were included in quality assurance procedure; 311 normal, 128 borderline and 44 abnormal. 2 (0.6%) normal HRT examinations were re-classified as borderline. 3 (2.7%) borderline HRT examinations were re-classified as abnormal.
Conclusions: The efficacy of a glaucoma screening program is increased when using two different diagnostic tools. A quality assured glaucoma screening program can detect with high sensitivity glaucoma suspects.