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Comment & Response
August 2016

Use of Multiple Tests Improves Screening for Glaucoma

Author Affiliations
  • 1Melbourne School of Population and Global Health, University of Melbourne, Carlton, Australia
JAMA Ophthalmol. 2016;134(8):947-948. doi:10.1001/jamaophthalmol.2016.1541

To the Editor Boland et al1 examined frequency-doubling technology (FDT) perimetry to screen for glaucoma, but the study may lead to potentially misleading conclusions.

An assessment of a diagnostic test needs a gold standard. The assessment of optic disc photographs, even if carefully done, is not a gold standard.

The authors examined whether FDT perimetry could identify “glaucoma, macular disease, or decreased visual acuity,”1 but this seems to have things backward. A patient with poor vision from macular disease or any other cause will have an abnormal FDT perimetry result and will require an ophthalmic referral anyway to address his or her poor vision.

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