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Osmers J, Kaiser N, Sorg M, Fischer A. Adaptive finite element eye model for the compensation of biometric influences on acoustic tonometry. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2021; 200:105930. [PMID: 33486338 DOI: 10.1016/j.cmpb.2021.105930] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 01/04/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND AND OBJECTIVE Glaucoma is currently a major cause for irreversible blindness worldwide. A risk factor and the only therapeutic control parameter is the intraocular pressure (IOP). The IOP is determined with tonometers, whose measurements are inevitably influenced by the geometry of the eye. Even though the corneal mechanics have been investigated to improve accuracy of Goldmann and air pulse tonometry, influences of geometric properties of the eye on an acoustic self-tonometer approach are still unresolved. METHODS In order to understand and compensate for measurement deviations resulting from the geometric uniqueness of eyes, a finite element eye model is designed that considers all relevant eye components and is adjustable to all physiological shapes of the human eye. RESULTS The general IOP-dependent behavior of the eye model is validated by laboratory measurements on porcine eyes. The difference between simulation and measurement is below 8 µm for IOP levels from 5 to 40 mmHg. The adaptive eye model is then used to quantify systematic uncertainty contributions of a variation of eye length and central corneal thickness based on input statistics of a clinical trial series. The adaptive eye model provides the required relation between biometric eye parameters and the corneal deflection amplitude, which here is the measured quantity to trace back to the IOP. Implementing the relations provided by the eye model in a Gaussian uncertainty propagation calculation now allows the quantification of the uncertainty contributions of the biometric parameters on the overall measurement uncertainty of the acoustic self-tonometer. As a result, a systematic uncertainty contribution resulting from deviations in eye length dominate stochastic deviations of the sensor equipment by a factor of 3.5. CONCLUSION As perspective, the proposed adaptive eye model provides the basis to compensate for systematic deviations of (but not only) the acoustic self-tonometer.
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Affiliation(s)
- Jan Osmers
- University of Bremen, Bremen Institute for Metrology, Automation and Quality Science (BIMAQ), Linzer Str. 13, Bremen 28359, Germany.
| | - Nils Kaiser
- University of Bremen, Bremen Institute for Metrology, Automation and Quality Science (BIMAQ), Linzer Str. 13, Bremen 28359, Germany
| | - Michael Sorg
- University of Bremen, Bremen Institute for Metrology, Automation and Quality Science (BIMAQ), Linzer Str. 13, Bremen 28359, Germany
| | - Andreas Fischer
- University of Bremen, Bremen Institute for Metrology, Automation and Quality Science (BIMAQ), Linzer Str. 13, Bremen 28359, Germany
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Chen M, Zhang L, Xu J, Chen X, Gu Y, Ren Y, Wang K. Comparability of three intraocular pressure measurement: iCare pro rebound, non-contact and Goldmann applanation tonometry in different IOP group. BMC Ophthalmol 2019; 19:225. [PMID: 31726999 PMCID: PMC6857285 DOI: 10.1186/s12886-019-1236-5] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Accepted: 11/01/2019] [Indexed: 01/23/2023] Open
Abstract
Background Measurement of intraocular pressure (IOP) is essential for glaucoma patients. Many factors such as central corneal thickness (CCT) can affect the accuracy of IOP measurement. The purpose of this study was to evaluate the agreement of IOP measured by non-contact tonometer (NCT), iCare pro rebound tonometer (iCare), and Goldmann applanation tonometer (GAT) in different IOP group. Methods This was a Hospital-based cross-sectional study. Two hundred subjects were enrolled in this study. All subjects underwent IOP measurement using an NCT–iCare–GAT sequence. Bland-Altman, Pearson correlation and intraclass correlation analysis were performed using SPSS 17.0 software. The influence of CCT on each IOP measurement methods was evaluated by linear regression analysis. Results The mean difference (Δ) of NCT–GAT did not differ from (Δ) iCare–GAT in IOP < 10 and 10–21 mmHg group. However, (Δ) NCT–GAT was significantly higher than (Δ) iCare–GAT in IOP 22–30 and > 30 mmHg group (P < 0.05). Bland–Altman analysis showed significant agreement between the three devices (P < 0.01). IOP measurements of the three methods were significantly correlated with CCT (P < 0.01). Conclusions ICare pro shows a higher agreement with GAT over a wide range of IOP compared with NCT. The consistency between the three tonometers was similar in a low and normal IOP range. However, NCT shows a greater overestimate of IOP in moderate and higher IOP group. The variability of IOP measurement affected by CCT is NCT > iCare pro > GAT.
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Affiliation(s)
- Min Chen
- Eye Center, the 2nd Affiliated Hospital, Medical College of Zhejiang University, No.88 Jiefang Road, Hangzhou, 310009, China.,Zhejiang Provincial Key Lab of Ophthalmology, Hangzhou, China
| | - Lina Zhang
- Eye Center, the 2nd Affiliated Hospital, Medical College of Zhejiang University, No.88 Jiefang Road, Hangzhou, 310009, China.,Lishui People's Hospital, Lishui, Zhejiang, China
| | - Jia Xu
- Eye Center, the 2nd Affiliated Hospital, Medical College of Zhejiang University, No.88 Jiefang Road, Hangzhou, 310009, China.,Zhejiang Provincial Key Lab of Ophthalmology, Hangzhou, China
| | - Xinyi Chen
- Eye Center, the 2nd Affiliated Hospital, Medical College of Zhejiang University, No.88 Jiefang Road, Hangzhou, 310009, China.,Zhejiang Provincial Key Lab of Ophthalmology, Hangzhou, China
| | - Yuxiang Gu
- Eye Center, the 2nd Affiliated Hospital, Medical College of Zhejiang University, No.88 Jiefang Road, Hangzhou, 310009, China.,Zhejiang Provincial Key Lab of Ophthalmology, Hangzhou, China
| | - Yuping Ren
- Shaoxing Traditional Chinese Medicine Hospital, Shaoxing, Zhejiang, China
| | - Kaijun Wang
- Eye Center, the 2nd Affiliated Hospital, Medical College of Zhejiang University, No.88 Jiefang Road, Hangzhou, 310009, China. .,Zhejiang Provincial Key Lab of Ophthalmology, Hangzhou, China.
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Fayed MA, Chen TC. Pediatric intraocular pressure measurements: Tonometers, central corneal thickness, and anesthesia. Surv Ophthalmol 2019; 64:810-825. [DOI: 10.1016/j.survophthal.2019.05.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Revised: 05/15/2019] [Accepted: 05/20/2019] [Indexed: 11/17/2022]
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