To describe the frequency doubling technology (FDT) methodology to measure visual field loss in the National Health and Nutrition Examination Survey and to evaluate data reliability.
Participants aged 40 years and older were eligible (n = 2,529) for 2 visual field tests per eye performed with the Humphrey Matrix N-30-5 screening test. Visual field loss was determined using a 2-2-1 algorithm requiring 2 complete tests per eye, with at least 2 abnormal field results in each test, and 1 common abnormal field.
Response rate was 86.2%. Time constraints were the main reason for no exam (55.6%). Median times were: single test, 37 seconds; entire exam, 9.1 minutes. When defining reliability based on ≤ 1/3 blind spots, ≤ 1/3 false positive tests, and technician noted proper fixation, 80.1% of examined adults had 2 reliable tests for both eyes; an additional 13.4% had 2 reliable tests for 1 eye. Increasing age, decreasing visual acuity, and the presence of self-reported glaucoma resulted in decreased examination rates, increased test times, and decreased data reliability. Sensitivity and specificity to detect persons with glaucoma was 54.8% and 91.9%, respectively.
FDT is a feasible, fast, and reliable method for visual field loss screening in a population-based U.S. study, with an 86.2% response rate, median exam time ~9 minutes, and nearly 95% of examined participants having complete, reliable results in 1 or both eyes.
"A large scale project used a different type of instrument, a more complex version of FDT, Matrix FDT with smaller five degree targets and with more targets, to screen over 2,000 participants forty years of age or older in the National Health and Nutrition Examination Survey. The Matrix FDT used was found to be reliable in eighty percent of those tested; with large reductions in acuity, glaucoma, and age reported to be the major contributions to unreliable tests . "
[Show abstract][Hide abstract] ABSTRACT: This study was to investigate the feasibility of frequency doubling technology (FDT) visual field testing in Alzheimer's disease (AD) in order to identify early biomarkers of AD in patients already diagnosed with AD and compare the findings to participants not having Alzheimer's disease. This biomarker would be useful in a battery of tests for the early identification of those with AD. It was not the intent to correlate the visual system biomarker with severity of disease, but to determine if the biomarker was present in pass or fail screening criteria. The study showed with very strong significance that the FDT can identify biomarkers of those with AD compared to an age-matched population that does not have AD. FDT is a simple test to take and administer and has been used to screen for eye and retinal diseases such as glaucoma, retinal macular degeneration, and diabetic retinopathy. The results obtained in the FDT readout are analyzed and compared to the age normative database within the system. The FDT ability to screen for AD biomarker in the visual system was significant in those with AD compared to the controls, and the deficits were not related to any ocular pathology.
[Show abstract][Hide abstract] ABSTRACT: To investigate the relationship between supplementary consumption of the oxidants calcium and iron and the prevalence of glaucoma.
This cross-sectional study included 3833 participants in the National Health and Nutrition Examination Survey (NHANES) for 2007 and 2008, ≥ 40 years of age, who reported a presence or absence of glaucoma. Participants were interviewed regarding the use of dietary supplements and antacids during the preceding 30-day period. Data pertaining to the supplementary intake of calcium and iron was aggregated and divided into quintiles. Information regarding the presence or absence of glaucoma and demographics, comorbidities, and health-related behavior was obtained via interview.
Participants who consumed ≥ 800 mg/d of supplementary calcium or ≥ 18 mg/d of supplementary iron had significantly higher odds of having been diagnosed with glaucoma than did those who had not consumed supplementary calcium or iron, after adjustment for potential confounders (odds ratio [OR] 2.44, 95% confidence interval [CI] 1.25-4.76 for calcium; OR 3.80, 95% CI 1.79-8.06 for iron). Concurrent consumption of both calcium and iron above these levels was associated with still greater odds of having been diagnosed with glaucoma (OR 7.24, 95% CI 2.42-21.62). A clear dose-response relationship between quintiles of supplementary calcium or iron intake and glaucoma prevalence was not found.
These results suggest that there may be a threshold intake of iron and calcium above which there is an increased risk of development of glaucoma. Prospective longitudinal studies are needed, to assess whether oxidant intake is a risk factor for development and progression of glaucoma.
Dan Luo, Yali Qin, Wei Yuan, Hui Deng, Youhua Zhang, Ming Jin
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