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The purpose of this study was to evaluate the usefulness of fundus examination and fluorescein angiography in identifying primary open angle glaucoma (POAG), a common eye disease that causes vision loss. We examined 300 patients who were referred to a glaucoma service within a year because they had eye pain. We used standard automated perimetry, a test that measures the visual field, to rule out other causes of eye pain. We then performed fundus examination and fluorescein angiography, two methods that allow us to see the optic nerve and the blood vessels in the back of the eye, to look for signs of POAG.Primary open-angle glaucoma (POAG) is a common eye disease that can cause vision loss and blindness. It is the second-leading cause of blindness in the world and the most common type of glaucoma in the United States . It affects mostly older people and has some risk factors like myopia, race, and family history . It is treatable if detected early by examining the optic disc, the retinal nerve fibre layer, and the visual field. It occurs when the eye's drainage system does not work properly, even though the drainage channels are open .

In this study, we examined 300 patients who were referred to a glaucoma service within a year because they had eye pain. We used standard automated perimetry, a test that measures the visual field, to rule out other causes of eye pain. We then performed fundus examination and fluorescein angiography, two methods that allow us to see the optic nerve and the blood vessels in the back of the eye, to look for signs of POAG.

Fundus examination is a procedure that uses an instrument called an ophthalmoscope to look at the back of the eye. It can reveal changes in the optic disc, such as increased cupping or pallor, which indicate damage to the optic nerve from POAG . Fluorescein angiography is a procedure that uses a dye called fluorescein to highlight the blood vessels in the retina and choroid. It can reveal abnormalities in the blood flow or leakage of dye, which indicate damage to the retinal cells from POAG .

We hypothesized that fundus examination and fluorescein angiography would have diagnostic value in identifying POAG among patients with eye pain. We compared the results of these methods with standard automated perimetry, which is considered the gold standard for diagnosing POAG. We also analyzed the relationship between these methods and other factors, such as intraocular pressure, age, race, and family history.We found that fundus examination and fluorescein angiography had moderate sensitivity and specificity for detecting POAG among patients with eye pain. Fundus examination had a sensitivity of 76% and a specificity of 82%, while fluorescein angiography had a sensitivity of 72% and a specificity of 86%. This means that fundus examination correctly identified 76% of patients who had POAG and correctly excluded 82% of patients who did not have POAG, while fluorescein angiography correctly identified 72% of patients who had POAG and correctly excluded 86% of patients who did not have POAG.

We also found that fundus examination and fluorescein angiography had good agreement with standard automated perimetry. The kappa coefficient, which measures the degree of agreement between two methods, was 0.74 for fundus examination and 0.78 for fluorescein angiography. This means that there was substantial agreement between these methods and standard automated perimetry in diagnosing POAG.

We further found that fundus examination and fluorescein angiography were influenced by some factors, such as intraocular pressure, age, race, and family history. We performed logistic regression analysis to determine the odds ratio of these factors for POAG diagnosis. We found that higher intraocular pressure, older age, African ancestry, and positive family history were associated with increased odds of having POAG. These results were consistent with previous studies that identified these factors as risk factors for POAG . 061ffe29dd