Detection of Intraocular Hypertension during Opportunity Screening (Check-Up Medical Inspections)

Abstract

The aim of the study is the early detection of OHT (Ocular hypertension) in patients, in the activity of secondary prophylaxis (opportunity screening-medical check-up), to prevent blindness caused by POAG (Primary Open Angle Glaucoma). In Romania, medical examination of personnel with responsibilities in Transport Safety (TS) is legally regulated, being mandatory as a result of the internal transposition of European legislation in the field. The addressability of the patients for examination was determined by personal choice, depending on the accessibility of the medical service on the profile market (availability and price). The design of the study is epidemiological, observational, descriptive and retrospective. The standardized medical protocol included: personal medical history (anamnesis), physical ophthalmological examination, Intraocular pressure (IOP) measurement and Visual Field (VF) performance, with Automated Perimeter “Optopol PTS 910” through “Fast Threshold” strategy. The specialized medical research was completed with a dichotomous questionnaire entitled “Symptom Inventory”, made according to the recommendations of patients resulting from “Focus group” research. The study was carried out within the “Check-up” type medical controls upon request, only for personnel with positions in Transport Safety (TS), during January–December 2021 at S.C. ARTIMED S.R.L. Oradea, Bihor County. Health analysis was performed for 820 people, of whom 71 people (8.65%) tested positive for IOP > 21 mmHg, (suspected OHT) compared to 749 (91.35%) with normal values (Normal intraocular pressure-NIOP); the two lots being statistically significantly different (x2 = 560.590, df = 1, p = 0.000). The study involved 754 men (92.0%) and 66 women (8.0%), the sex ratio is 11.42 (Exp (B) = 0.782, Sig = 0.558, 95% CI = 0.343–1783; sex is not a significant predictor at the 5% level). The prevalence of OHT was 8.66% for the whole group, 8.48% for men and 10.60% for women. In the screening action for the whole group of patients the following was determined: IOP reference = 20.85 mmHg, Sensitivity (Se) = 91.5% and 1-Specificity (Sp) = 0.073, (Sp = 92.7%). The predictive value of the screening test was: Positive Predictive Value (PPV) = 90.1% and Negative Predictive Value (NPV) = 91.7%; Area under the ROC Curve (Receiver Operating Characteristic) = 0.986, Sig. = 0.000, CI95% = 0.979–0.993. A binary logistical model of a questionnaire was developed to determine the screening parameters which significantly predicted OHT: IOP (OR = 4.154, 95% CI: 3.155–5.469), Age < 40 years (OR = 0.408, 95% CI: 0.239–0.698) and Pattern Defect (PD) (OR = 1.475% CI: 1.130–1.925). The results of this study assess health status through regular medical examinations, and highlight their importance and usefulness in secondary prevention activity. The particularity of this “check-up” type for personnel with attributions in transport safety is based on two essential aspects: the legal obligation to perform it and the fact it is financed by the beneficiary (the employer). In patients suspected of OHT after antiglaucoma treatment, IOP statistically significantly decreased.

Agreement on Anterior Chamber Depth Measurement between Three Commercially Available Devices

“…Participants were excluded if they had a history of conjunctival, scleral or corneal disease, a dry eye disease diagnosis, glaucoma, a history of ocular surgery and/or diabetes mellitus, thyroid disorders, hypersensitivity or an allergy to anaesthesia, and/or systemic disorders that could affect the measurements [27,29,30]. From the initial recruited group, participants were included in the analysis if their refractive spherical error was between +4.00 and −10.00 D with a cylindrical error equal to or lower than −3.00 D [16,27], keratometry readings in both the flatter and steeper meridian equal to or less than 47.2 D [31], an intraocular pressure (IOP) equal to or lower than 21 mmHg [32][33][34] and an anterior chamber angle (ACA), both nasal and temporal, equal to or higher than 30 • [5,35]. No participants were undergoing topical or systemic treatment or utilizing artificial tears at the time of the study.…”

Comparison Between Ocular Biometric Parameters and Intraocular Pressure With and Without Contact Lenses

“…A total of 42 qualified volunteer participants (17 men and 25 women) with a mean age of 24.363.0 (from 19 to 33 years) from subjects attending the Optometry Clinic of the center were recruited. The inclusion criteria were as follows: an autorefracted sphere of 28.00 to +4.00 D, astigmatism of #3.00 D, 19,21 keratometric readings in both flatter and steeper meridian equal or lower to 47.20 D, 22 IOPcc equal or lower than 21.0 mm Hg, 11 and an anterior chamber angle both nasal and/or temporal equal or higher than 30°. 23 The exclusion criteria were as follows: history of conjunctival, scleral, or corneal disease, previous diagnosis of dry eye disease or glaucoma, a history of ocular surgery and/or, diabetes mellitus, thyroid disorders, hypersensitivity or allergy to anesthesia, and/or systemic disorders that could affect the measurements.…”

“…10 Another parameter of great relevance in daily routine visual assessment is the corneal compensated intraocular pressure (IOPcc), because of its relationship with pathologies such as glaucoma. 11…”

“…10 Another parameter of great relevance in daily routine visual assessment is the corneal compensated intraocular pressure (IOPcc), because of its relationship with pathologies such as glaucoma. 11 In the past decades, there has been a continuous increase in contact lenses (CL) prescriptions as an option for refractive compensation. 12 This increase could be due to factors such as the quality of vision with the CL, the inherent comfort for physical and leisure activities, or the full field of vision without interference from the frame, 13 as well as the development of CL for myopia control, which has boosted the use of CL in children.…”