SCREENING TECHNIQUES FOR ANGLE-CLOSURE GLAUCOMA IN RURAL TAIWAN

562 residents of Jin Shan aged 40 years and above underwent examinatio ns to compare the sensitivity and specificity of oblique flashlight, p eripheral slit beam and ultrasonographic evaluation of the anterior ch amber depth to gonioscopy in detecting cases of PACG, Among 5441 eligi ble individuals aged 40 and above, 562 (10.3%) underwent screening for PACG, of whom 17 (3.02%) were defined as cases, and 10 (1.78%) as sus pects. Home visits indicated that respondents for screening were simil ar to the population as a whole. Only 35% of PACG cases reported sympt oms consistent with acute angle closure, and only 18% were previously diagnosed. When compared to gonioscopy, only ultrasonographic measurem ent of AC depth provided an adequate mix of sensitivity and specificit y, Ultrasonography in combination with tonometry provided a sensitivit y of 88% with a specificity of 92%, Sensitivity and specificity for ul trasonography in combination with refractive status were 84% and 83% r espectively. Shallower AC depth (p = 0.0001), shorter axial globe leng th (p = 0.001), greater than 2D of hyperopia (p < 0.001), high grades of nuclear sclerotic cataract (p < 0.0001) and an increased cup-to-dis c ratio (p = 0.002) were significantly correlated with a diagnosis of PACG.