FDT Perimetry for Glaucoma Detection in Comprehensive Health Checkup Service

We aimed to investigate the efficacy of frequency doubling technology (FDT) perimetry for glaucoma detection in comprehensive screening examinations. We performed a retrospective analysis of prospectively collected data of participants who underwent a comprehensive health checkup service. Participants with glaucoma were excluded. In the first year, 2024 participants (46.8 ± 9.4 years) who underwent FDT perimetry and fundus photography were classified as the FDT group, whereas 3052 participants (42.2 ± 8.2 years) who underwent only fundus photography were classified as the non-FDT control group. Participants with abnormal findings on FDT perimetry and/or fundus photography were recommended to undergo further complete examination. All participants reported whether they had been newly diagnosed with glaucoma within 2 years of the first visit. In the FDT group, 23 (1.14%) participants were newly diagnosed with glaucoma. Among them, 20 (87.0%) had abnormal FDT perimetry findings and 12 (52.2%) had abnormal findings on fundus photography. The positive-predictive value (PPV) of FDT perimetry was 16.5% (20/121) and that of fundus photography was 13.3% (12/90). In participants with abnormal findings on both tests, the PPV was 26.2%. In the non-FDT group, 15 (0.49%) participants were newly diagnosed with glaucoma. Among them, 9 (60.0%) had abnormal findings on fundus photography. The PPV of fundus photography was 10.8% (9/83). The glaucoma detection rate, analyzed using age adjustment, was significantly higher in the FDT group than that in the non-FDT group (0.97% versus 0.47%, P=0.041). FDT perimetry, even if performed by nonspecialized physicians, could improve glaucoma detection when used in addition to fundus photography. This study was registered with UMIN000037951.