Abstract
Objetivos
Evaluar la utilidad de una estrategia de cribado de glaucoma e hipertensión ocular (HTO) medida como número de casos detectados. Evaluar la aceptabilidad de la toma de presión intraocular (PIO) y la aparición de efectos secundarios.
Diseño
Estudio descriptivo transversal.
Emplazamiento
Centro de salud urbano y consulta de oftalmología del hospital de referencia.
Participantes
En total, 2.044 pacientes mayores de 40 años, seleccionados por muestreo consecutivo entre los que consultaron en el centro de salud durante 9 meses. Se excluyeron los sujetos diagnosticados de glaucoma, HTO, conjuntivitis o enfermedad corneal.
Intervenciones
Toma de PIO con Tonopen XL en atención primaria. Se remitió a oftalmología a los sujetos con una PIO ≥ 21 mmHg. En éstos se midió la PIO con la prueba de Goldmann y, en los que se confirmó la HTO, se realizaron una oftalmoscopia y una campimetría.
Mediciones principales
Porcentaje de sujetos con glaucoma, sospecha de glaucoma e HTO confirmada en oftalmología. Valor predictivo positivo (VPP) para HTO.
Resultados
Se detectaron 100 sujetos con HTO (4,89%; intervalo de confianza [IC] del 95%, 3,93-5,85%), de los que 21 fueron diagnosticados de glaucoma (1,04%; IC del 95%, 0,57-1,49%) y 10 de sospecha de glaucoma (0,49%; IC del 95%, 0,16-0,82). El VPP para HTO fue del 44,27%. La aceptabilidad de la prueba fue del 98,09%. Ningún paciente presentó efectos secundarios tras la toma de la PIO.
Conclusiones
La estrategia evaluada es útil en cuanto al porcentaje de sujetos con glaucoma e HTO detectados. La aceptabilidad de la toma de la PIO con Tonopen XL es alta.
Palabras clave: Cribado, Hipertensión ocular, Atención primaria, Glaucoma
Abstract
Objectives
To evaluate the usefulness of a glaucoma and intraocular hypertension screening strategy for new cases detected. To evaluate the acceptability of taking intraocular pressure (IOP) and the appearance of side effects.
Design
Cross-sectional, descriptive study.
Setting
An urban health centre and the ophthalmology clinic of its main hospital.
Participants
A total of 2044 patients aged over 40, 63.5% women and 36.5% men, with a mean age of 61.23 (SD, 11.42). They were selected by consecutive sampling from patients who visited the health centre over a 9-month period. Subjects diagnosed with glaucoma, ocular hypertension (OH), conjunctivitis, or corneal pathology were excluded.
Interventions
Taking of IOP with Tonopen XL in primary care. Subjects with IOP ≥21 mm Hg were referred to ophthalmology. In these patients, IOP was measured with Goldmann, and patients with confirmed OH received ophthalmoscopy and campimetry.
Main measurements
Percentage of subjects with glaucoma, suspected glaucoma, and OH confirmed in ophthalmology. Positive predictive value (PPV) for OH.
Results
One hundred subjects with OH were detected (4.89%; 95% CI, 3.93%-5.85%), of whom 21 were diagnosed with glaucoma (1.04%; 95% CI, 0.57-1.49) and 10 with suspected glaucoma (0.49%; 95% CI, 0.16-0.82). The PPV for OH was 44.27%. The acceptability of the test was 98.09%. No patients presented with side-effects following the taking of their IOP.
Conclusions
The strategy evaluated is useful in terms of the number of subjects with glaucoma and OH detected. The acceptability of taking IOP with Tonopen XL was high.
Key words: Screening, Ocular hypertension, Primary care, Glaucoma
Footnotes
Fuente de financiación: FIS 99/0419.
Premios: Cura I, García de Blas, Barajas MA, Salvador C, Baza JM; Sanz T. Cribado de hipertensión ocular en atención primaria. Primer premio del XI Congreso de la SMMFYC, San Lorenzo del Escorial, Madrid, 12,13 abril 2002.
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