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September 1995

Impact of Age, Various Forms of Cataract, and Visual Acuity on Whole-Field Scotopic Sensitivity Screening for Glaucoma in Rural Taiwan

Arch Ophthalmol. 1995;113(9):1138-1143. doi:10.1001/archopht.1995.01100090064024

Objective:  To evaluate the impact of age, various forms of cataract, and visual acuity on whole-field scotopic sensitivity screening for glaucoma in a rural population.

Design:  Clinic-based study with population-based recruitment.

Setting:  Jin Shan Township near Taipei, Taiwan.

Subjects:  Three hundred forty-six residents (ages, ≥40 years) of Jin Shan Township.

Interventions:  Whole-field scotopic testing, ophthalmoscopy with dilation of the pupils, cataract grading against photographic standards, and screening visual field testing in a random one-third subsample.

Main Outcome Measures:  Whole-field scotopic sensitivity (in decibels) and diagnostic status as a case of glaucoma, glaucoma suspect, or normal.

Results:  Participants in Jin Shan Township did not differ significantly in the rate of blindness, low visual acuity, or family history of glaucoma from a random sample of nonrespondents. Scotopic sensitivity testing detected 100% (6/6) of subjects with open-angle glaucoma at a specificity of 80.2%. The mean±SE scotopic sensitivity for six subjects with open-angle glaucoma (32.78±1.51 dB) differed significantly from that of 315 normal individuals (38.51±0.22 dB), when adjusted for age and visual acuity (P=.05, t test). With linear regression modeling, factors that correlated significantly with scotopic sensitivity were intraocular pressure, screening visual field, best corrected visual acuity, presence of cortical cataract, and increasing age.

Conclusion:  Although cataract affects the whole-field scotopic threshold, it appears that scotopic testing may be of value in field-based screening for glaucoma.