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    Tablet-based tests putting detection of glaucoma at hand

    Remote visual function tests have potential as components of disease evaluation

    Boston—Though telemedicine has gained acceptance in the evaluation of patients with diabetic retinopathy and retinopathy of prematurity, it has yet to establish a solid niche in glaucoma.

    However, findings from a preliminary study suggest that portable visual function tests may be sufficiently accurate to play a role in glaucoma care, according to Brian J. Song, MD, instructor in ophthalmology, Massachusetts Eye and Ear Infirmary and Department of Ophthalmology, Harvard Medical School.

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    Dr. Song and colleagues evaluated the performance of several iPad-based visual function tests, comparing them with frequency-doubling technology (FDT).

    “None of the tests alone are sufficient for diagnosing glaucoma, but some of them have a high enough sensitivity or specificity that they could potentially be used in addition to other tests to improve the accuracy of the evaluation if you were to move to a complete telemedicine model the way certain other countries are starting to move,” Dr. Song said.

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    Eighty-two eyes of 82 patients with early manifest glaucoma and 38 eyes of 38 age-matched controls were evaluated at the Massachusetts Eye and Ear Infirmary. They underwent the same four tests in random order: FDT, the visualFields easy iPad app, blue arc entoptic phenomenon testing, and quick contrast sensitivity function (QCSF) testing.  

    Sensitivity, specificity, and positive and negative predictive values were calculated for all tests. Receiver operating characteristic (ROC) curves were plotted for the area under the log contrast sensitivity function (AULCSF) as well as the contrast sensitivity function acuity (CSF Acuity) of the QCSF test.

    Though the FDT is not iPad-based, it was included in the study since it is well validated and commonly used as a portable test in many glaucoma screening programs, Dr. Song said.

    Analyzing findings

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