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Buckhurst HD, Gilmartin B, Lam A, Cubbidge RP, Logan NS. In vivo measures of anterior scleral resistance in humans with rebound tonometry. Ophthalmic Physiol Opt 2020; 40:472-481. [PMID: 32495401 DOI: 10.1111/opo.12695] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Revised: 04/10/2020] [Accepted: 04/14/2020] [Indexed: 11/30/2022]
Abstract
PURPOSE To measure regional variations in anterior scleral resistance (ASR) using a ballistic rebound tonometer (RBT) and examine whether the variations are significantly affected by ethnicity and refractive error (RE). METHODS ASR was measured using a RBT (iCare TA01) following calibration against the biomechanical properties of agarose biogels. Eight scleral regions (nasal, temporal, superior, inferior, inferior-nasal, inferior-temporal, superior-nasal and superior-temporal) were measured at locations 4mm from the limbus. Subjects were 130 young adults comprising three ethnic groups whose RE distributions [MSE (D) ± S.D.] incorporated individuals categorised as without-myopia (NM; MSE ≥ -0.50) and with-myopia (WM; MSE < -0.50); British-White (BW): 26 NM + 0.52 ± 1.15D; 22 WM -3.83 ± 2.89D]; British-South-Asian (BSA): [9 NM + 0.49 ± 1.06D; 11 WM -5.07 ± 3.76D; Hong-Kong-Chinese (HKC): [11 NM + 0.39 ± 0.66D; 49 WM -4.46 ± 2.70D]. Biometric data were compiled using cycloplegic open-field autorefraction and the Zeiss IOLMaster. Two- and three-way repeated measures analysis of variances (anovas) tested regional differences for RBT values across both refractive status and ethnicity whilst stepwise forward multiple linear regression was used as an exploratory test. RESULTS Significant regional variations in ASR were identified for the BW, BSA and HKC (p < 0.001) individuals; superior-temporal region showed the lowest levels of resistance whilst the inferior-nasal region the highest. Compared to the BW and BSA groups, the HKC subjects displayed a significant increase in mean resistance for each respective region (p < 0.001). With the exception of the inferior region, ethnicity was found to be the chief predictor for variation in the scleral RBT values for all other regions. Mean RE group differences were insignificant. CONCLUSIONS The novel application of RBT to the anterior sclera confirm regional variation in ASR. Greater ASR amongst the HKC group than the BW and BSA individuals suggests that ethnic differences in anterior scleral biomechanics may exist.
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Affiliation(s)
- Hetal D Buckhurst
- Eye and Vision Research Group, School of Health Professions, Faculty of Health, Plymouth University, Plymouth, UK
| | | | - Andrew Lam
- School of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong
| | | | - Nicola S Logan
- School of Life & Health Sciences, Aston University, Birmingham, UK
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Vandewalle E, Vandenbroeck S, Stalmans I, Zeyen T. Comparison of ICare, Dynamic Contour Tonometer, and Ocular Response Analyzer with Goldmann Applanation Tonometer in Patients with Glaucoma. Eur J Ophthalmol 2018; 19:783-9. [PMID: 19787598 DOI: 10.1177/112067210901900516] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
| | - Sofie Vandenbroeck
- Department of Ophthalmology, University Hospitals Leuven
- Center for Health Services and Nursing Research, Katholieke Universiteit Leuven - Belgium
| | | | - Thierry Zeyen
- Department of Ophthalmology, University Hospitals Leuven
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Pahlitzsch M, Brünner J, Gonnermann J, Maier AKB, Torun N, Bertelmann E, Klamann MK. Comparison of ICare and IOPen vs Goldmann applanation tonometry according to international standards 8612 in glaucoma patients. Int J Ophthalmol 2016; 9:1624-1628. [PMID: 27990366 DOI: 10.18240/ijo.2016.11.14] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2015] [Accepted: 05/16/2016] [Indexed: 11/23/2022] Open
Abstract
AIM To compare IOPen and ICare rebound tonometry to Goldmann applanation tonometry (GAT) according to International Standards Organization (ISO) 8612 criteria. METHODS Totally 191 eyes (n=107 individuals) were included. Criteria of ISO 8612 were fulfilled: 3 clusters of IOP, measured by GAT, were formed. The GAT results were given as mean±standard deviation. RESULTS GAT (19.7±0.5 mm Hg) showed a significant correlation to ICare (19.8±0.5 mm Hg) (r=0.547, P<0.001) and IOPen (19.5±0.5 mm Hg) (r=0.526, P<0.001). According to ISO 8612 criteria in all 3 IOP groups the number of outliers (of the 95% limits of agreement) exceeded 5% for ICare and IOPen vs GAT: No.1 (n=68) 29.4% and 22.1%, No.2 (n=62) 35.5% and 37.1%, No.3 (n=61) 26.2% and 42.6%, respectively. CONCLUSION The strict requirements of the ISO 8612 are not fulfilled in a glaucoma collective by ICare and IOPen at present. As long as the Goldmann tonometry is applicable it should be used first of all for reproducible IOP readings. ICare and IOPen tonometry should be considered as an alternative tool, if application of Goldmann tonometry is not possible.
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Affiliation(s)
- Milena Pahlitzsch
- Glaucoma and Retinal Degeneration Research Group, UCL, Institute of Ophthalmology, Bath Street, London, EC1V 9EL, United Kingdom
| | - Jeanette Brünner
- Department of Ophthalmology, Campus Virchow Clinic, Charite University Medicine, Augustenburger Platz 1, Berlin13353, Germany
| | - Johannes Gonnermann
- Department of Ophthalmology, Campus Virchow Clinic, Charite University Medicine, Augustenburger Platz 1, Berlin13353, Germany
| | - Anna-Karina B Maier
- Department of Ophthalmology, Campus Virchow Clinic, Charite University Medicine, Augustenburger Platz 1, Berlin13353, Germany
| | - Necip Torun
- Department of Ophthalmology, Campus Virchow Clinic, Charite University Medicine, Augustenburger Platz 1, Berlin13353, Germany
| | - Eckart Bertelmann
- Department of Ophthalmology, Campus Virchow Clinic, Charite University Medicine, Augustenburger Platz 1, Berlin13353, Germany
| | - Matthias Kj Klamann
- Department of Ophthalmology, Campus Virchow Clinic, Charite University Medicine, Augustenburger Platz 1, Berlin13353, Germany
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Abstract
Foreword It gives me pleasure to introduce the 4th edition of the EGS Guidelines. The Third edition proved to be extremely successful, being translated into 7 languages with over 70000 copies being distributed across Europe; it has been downloadable, free, as a pdf file for the past 4 years. As one of the main objectives of the European Glaucoma Society has been to both educate and standardize glaucoma practice within the EU, these guidelines were structured so as to play their part. Glaucoma is a living specialty, with new ideas on causation, mechanisms and treatments constantly appearing. As a number of years have passed since the publication of the last edition, changes in some if not all of these ideas would be expected. For this new edition of the guidelines a number of editorial teams were created, each with responsibility for an area within the specialty; updating where necessary, introducing new diagrams and Flowcharts and ensuring that references were up to date. Each team had writers previously involved with the last edition as well as newer and younger members being co-opted. As soon as specific sections were completed they had further editorial comment to ensure cross referencing and style continuity with other sections. Overall guidance was the responsibility of Anders Heijl and Carlo Traverso. Tribute must be made to the Task Force whose efforts made the timely publication of the new edition possible. Roger Hitchings Chairman of the EGS Foundation www.eugs.org The Guidelines Writers and Contributors Augusto Azuara Blanco Luca Bagnasco Alessandro Bagnis Keith Barton Christoph Baudouin Boel Bengtsson Alain Bron Francesca Cordeiro Barbara Cvenkel Philippe Denis Christoph Faschinger Panayiota Founti Stefano Gandolfi David Garway Heath Francisco Goni Franz Grehn Anders Heijl Roger Hitchings Gabor Hollo Tony Hommer Michele Iester Jost Jonas Yves Lachkar Giorgio Marchini Frances Meier Gibbons Stefano Miglior Marta Misiuk-Hojo Maria Musolino Jean Philippe Nordmann Norbert Pfeiffer Luis Abegao Pinto Luca Rossetti John Salmon Leo Schmetterer Riccardo Scotto Tarek Shaarawy Ingeborg Stalmans Gordana Sunaric Megevand Ernst Tamm John Thygesen Fotis Topouzis Carlo Enrico Traverso Anja Tuulonen Ananth Viswanathan Thierry Zeyen The Guidelines Task Force Luca Bagnasco Anders Heijl Carlo Enrico Traverso Augusto Azuara Blanco Alessandro Bagnis David Garway Heath Michele Iester Yves Lachkar Ingeborg Stalmans Gordana Sunaric Mégevand Fotis Topouzis Anja Tuulonen Ananth Viswanathan The EGS Executive Committee Carlo Enrico Traverso (President) Anja Tuulonen (Vice President) Roger Hitchings (Past President) Anton Hommer (Treasurer) Barbara Cvenkel Julian Garcia Feijoo David Garway Heath Norbert Pfeiffer Ingeborg Stalmans The Board of the European Glaucoma Society Foundation Roger Hitchings (Chair) Carlo E. Traverso (Vice Chair) Franz Grehn Anders Heijl John Thygesen Fotis Topouzis Thierry Zeyen The EGS Committees CME and Certification Gordana Sunaric Mégevand (Chair) Carlo Enrico Traverso (Co-chair) Delivery of Care Anton Hommer (Chair) EU Action Thierry Zeyen (Chair) Carlo E. Traverso (Co-chair) Education John Thygesen (Chair) Fotis Topouzis (Co-chair) Glaucogene Ananth Viswanathan (Chair) Fotis Topouzis (Co-chair) Industry Liaison Roger Hitchings (Chair) Information Technology Ingeborg Stalmans (Chair) Carlo E. Traverso (Co-chair) National Society Liaison Anders Heijl (Chair) Program Planning Fotis Topouzis (Chair) Ingeborg Stalmans (Co-chair) Quality and Outcomes Anja Tuulonen (Chair) Augusto Azuara Blanco (Co-chair) Scientific Franz Grehn (Chair) David Garway Heath (Co-chair)
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Affiliation(s)
- Alireza Mashaghi
- Schepens Eye Research Institute, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, USA
| | - Jiaxu Hong
- Schepens Eye Research Institute, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, USA
| | - Sunil K Chauhan
- Schepens Eye Research Institute, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, USA
| | - Reza Dana
- Schepens Eye Research Institute, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, USA
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Garcia-Feijoo J, Martinez-de-la-Casa JM, Morales-Fernandez L, Saenz Frances F, Santos-Bueso E, Garcia-Saenz S, Mendez-Hernandez C. New technologies for measuring intraocular pressure. PROGRESS IN BRAIN RESEARCH 2015; 221:67-79. [DOI: 10.1016/bs.pbr.2015.06.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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Yung E, Trubnik V, Katz LJ. An overview of home tonometry and telemetry for intraocular pressure monitoring in humans. Graefes Arch Clin Exp Ophthalmol 2014; 252:1179-88. [DOI: 10.1007/s00417-014-2668-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2013] [Revised: 04/29/2014] [Accepted: 05/06/2014] [Indexed: 11/24/2022] Open
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Klamann MKJ, Maier AKB, Gonnermann J, Torun N, Ruokonen PC. [Influence of corneal thickness on intraocular pressure measurements following Descemet's stripping automated endothelial keratoplasty (DSAEK)]. Ophthalmologe 2013; 109:1093-7. [PMID: 22752628 DOI: 10.1007/s00347-012-2623-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND The aim of this study was to evaluate the effect of increased corneal thickness after Descemet's stripping automated endothelial keratoplasty (DSAEK) on intraocular pressure (IOP) measured by four different techniques. METHODS In this study 30 eyes from 30 patients with successful DSAEK treatment (group 1) and 30 eyes of 30 healthy subjects (group 2) were enrolled. The IOP was measured with iCare, IOPen, Goldmann applanation tonometry (GAT) and dynamic contour tonometry (DCT) techniques. Central corneal thickness (CCT) was measured by ultrasonic pachymetry. These data were used for statistical analysis. RESULTS The mean IOP measured by GAT, DCT, iCare and IOPen was 13.2, 16.1, 12.5 and 14.2 mmHg in group 1 and 13.4, 14.4, 14.4 and 13.3 mmHg in group 2, respectively. Correlations between IOP and CCT were not statistically significant in either group. CONCLUSION The results of IOP measurements by the iCare, IOPen, GAT and DCT techniques seem to be unrelated to artificially thickened corneas after DSAEK. In spite of partially good correlation between the four techniques a direct exchange of the devices is not recommended on account of the wide dispersion of values.
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Affiliation(s)
- M K J Klamann
- Department of Ophthalmology, University Medicine Charité Berlin, Augustenburger Platz 1, 13353, Berlin, Deutschland.
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Lee K, Lee JY, Moon JI, Park MH. Comparison of Icare Rebound Tonometer with Goldmann Applanation Tonometry. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2013. [DOI: 10.3341/jkos.2013.54.2.296] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Kook Lee
- Department of Ophthalmology and Visual Science, Yeouido St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Ji Young Lee
- Department of Ophthalmology and Visual Science, Yeouido St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Jung Il Moon
- Department of Ophthalmology and Visual Science, Yeouido St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Myoung Hee Park
- Department of Ophthalmology and Visual Science, Yeouido St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
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Halkiadakis I, Stratos A, Stergiopoulos G, Patsea E, Skouriotis S, Mitropoulos P, Papaconstantinou D, Georgopoulos G. Evaluation of the Icare-ONE rebound tonometer as a self-measuring intraocular pressure device in normal subjects. Graefes Arch Clin Exp Ophthalmol 2012; 250:1207-11. [PMID: 22297535 DOI: 10.1007/s00417-011-1875-6] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2011] [Revised: 11/07/2011] [Accepted: 11/15/2011] [Indexed: 10/14/2022] Open
Abstract
PURPOSE To compare Icare ONE rebound self-tonometer (ICRBT) measurements with Goldman applanation tonometry (GAT). METHODS A trained examiner instructed each of 60 normal subjects on use of the ICRBT. Each subject then took two measurements of his/her own pressure using the ICRBT. Finally, a different examiner, who was masked to the earlier readings, measured IOP by GAT. Bland–Altman limits of agreement (LOA), intraclass correlation coefficients (ICCs), Kappa values, and paired t-test were used to assess the agreement between the two methods. Pearson’s correlation coefficient was used for correlation analysis. RESULTS All of the subjects were able to obtain correct measurements with ICRBT after three attempts. The mean intraocular pressure with ICRBT and GAT measurements were 16.0 ± 3.3 mmHg and 13.7 ± 2.5 mmHg respectively. The mean difference between patient’s ICRBT and technician’s GAT measurements was 2.3 mmHg (p < 0.001). In 63% (38/60) of the cases the IOP difference (ICRBT − GAT) was within ± 3 mmHg. The weighted Kappa for the IOP measurements of the two methods was 0.49 (95% CI: 0.30–0.68, p < 0.001), indicating acceptable agreement. A significantly positive correlation was found between ICRBT IOP measurements and central corneal thickness (CCT) (r = 0.48, p < 0.001). In addition, the difference in IOP measurements (ICRBT − GAT) between the two methods was positively correlated with CCT (r = 0.31, p = 0.015), indicating that greater thickness is associated with greater differences between the two methods. CONCLUSION The ICRBT was reliable in the hands of normal subjects, and may be used for self-monitoring of IOP. ICRBT measurements generally overestimated GAT measurements.
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Affiliation(s)
- Ioannis Halkiadakis
- Ophthalmiatrion Athinon, Athens Eye Hospital, Konstadinoupoleos 17 Marousi, 15124 Athens, Greece.
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Abstract
PURPOSE The aim of this article is to present a case of acute glaucoma arising in a closed eye 10 days after lower eyelid reconstruction by Hughes tarsoconjunctival flap technique and to discuss clinical strategies to avoid this complication. CASE REPORT A 61-year-old hyperopic patient presented with a basal cell carcinoma of the lower eyelid. After 2-step tumor resection eyelid reconstruction was performed by Hughes tarsoconjunctival flap technique but 1 week later the patient presented with headache and pain in the contralateral eye. Acute glaucoma was diagnosed and successfully treated (mannitol, aceatazolamide i.v., topical pilocarpine and iridotomy). Some days later the patient came back with relapsed headache and pain in the closed eye. Although the intraocular pressure (IOP) could not be measured acute glaucoma of the right eye as well was suspected and the patient was treated again with mannitol and acetazolamide. As the pain resolved under this therapy the closed eyelid was not opened at this time but the lid reopening was performed at the regular time point (4 weeks postoperatively). CONCLUSIONS To the best of our knowledge this is the first published case of an acute glaucoma arising in a topically uncontrolled treatable eye with sutured eyelids. The risk of insufficient treatable acute glaucoma should be included in the patient informed consent when planning eyelid reconstruction by Hughes tarsoconjunctival flap technique. The case supports experimental research efforts to establish techniques of transpalpebral IOP measurement.
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Muttuvelu DV, Baggesen K, Ehlers N. Precision and accuracy of the ICare tonometer - Peripheral and central IOP measurements by rebound tonometry. Acta Ophthalmol 2012; 90:322-6. [PMID: 20840218 DOI: 10.1111/j.1755-3768.2010.01987.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
PURPOSE The purpose of this study was to evaluate the ICare tonometers precision and accuracy and the extent to which intraocular pressure (IOP) measurements are influenced by measuring position. METHODS This was carried out by comparing the central and peripheral ICare-IOP readings and comparing ICare- with the Goldmann applanation tonometer (GAT)-IOP readings. IOP was measured using the ICare rebound tonometer on the right eye of 40 subjects, straight at the centre of the cornea (CS), straight 2 mm from the nasal and temporal limbus (NS and TS), and in 10 degrees nasally and temporally angled positions measured from the same location as CS (NA and TA). The IOP was also assessed with the GAT. RESULTS Central IOP (CS) was significantly (p < 0.001) greater than peripheral measurements (NS, TS, NA and TA) by approximately 3-4 mmHg. Centre IOP (CS) significantly overestimated by mean 2 mmHg and the peripheral measurements significantly underestimates approximately 1.4-2 mmHg compared with GAT readings. CONCLUSION The ICare tonometer may be useful in a routine clinical setting for IOP screening, but the ICare measurement is not a substitute for the GAT measurement, when a precise and accurate IOP is desired.
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Affiliation(s)
- Danson V Muttuvelu
- Department of Ophthalmology, Aalborg Hospital - Århus University Hospital, Denmark.
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Martinez-de-la-Casa JM, Jimenez-Santos M, Saenz-Frances F, Matilla-Rodero M, Mendez-Hernandez C, Herrero-Vanrell R, Garcia-Feijoo J. Performance of the rebound, noncontact and Goldmann applanation tonometers in routine clinical practice. Acta Ophthalmol 2011; 89:676-80. [PMID: 19900196 DOI: 10.1111/j.1755-3768.2009.01774.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
PURPOSE To compare rebound tonometry (RBT) and noncontact tonometry (NCT) using Goldmann applanation tonometry (GAT) as reference. METHODS The study sample was comprised of 108 eyes of 108 subjects consecutively examined at a general ophthalmology clinic. The order of use of the three tonometers was randomized at the study outset. The difference between the methods was plotted against the mean to compare the tonometers. The hypothesis of zero bias was examined by a paired t-test and 95% limits of agreement (LoA) were also calculated. Differences with respect to GAT were assessed according to the international standard for ocular tonometers (ISO 8612). RESULTS Mean intraocular pressures (IOPs ± SD) obtained using the three instruments were GAT 17.5 ± 3.8 mmHg; RBT 18.5 ± 5.5 mmHg and NCT 17.4 ± 5.6 mmHg. The 95% LoA were from -7.9 to +7.7 mmHg for NCT-GAT and from -6.8 mmHg to +8.7 mmHg for RBT-GAT. A difference with respect to GAT under ± 1 mmHg was observed in 11.1% of the eyes measured by NCT and 18.5% of eyes measured by RBT. According to the IOP ranges established by the ISO 8612, differences from GAT measurements greater than ± 5 mmHg were always above the accepted level of 5%. Correlations between IOP and central corneal thickness (CCT) were significant for all three tonometers. CONCLUSIONS The rebound and noncontact tonometer behaved similarly when used to measure IOP taking GAT measurements as the reference standard. Neither tonometer fulfilled ISO 8612 requirements. Both were similarly influenced by CCT.
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Affiliation(s)
- Jose M Martinez-de-la-Casa
- Hospital Clinico San Carlos, Instituto de Investigaciones Oftalmologicas Ramon Castroviejo, Universidad Complutense, Madrid, Spain.
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Flemmons MS, Hsiao YC, Dzau J, Asrani S, Jones S, Freedman SF. Icare rebound tonometry in children with known and suspected glaucoma. J AAPOS 2011; 15:153-7. [PMID: 21419676 DOI: 10.1016/j.jaapos.2010.11.022] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2010] [Revised: 11/15/2010] [Accepted: 11/15/2010] [Indexed: 10/18/2022]
Abstract
BACKGROUND Accurate intraocular pressure (IOP) measurement, important in managing pediatric glaucoma, often presents challenges. The Icare rebound tonometer shows promise for screening healthy children and has been reported comparable with Goldmann applanation in adults with glaucoma. The purpose of this study was to evaluate the Icare tonometer against Goldmann applanation for clinic IOP measurement in pediatric glaucoma. METHODS This was a prospective study comparing Icare versus Goldmann tonometry in pediatric glaucoma. Children with known or suspected glaucoma were recruited from scheduled clinic visits. IOP was measured with the Icare tonometer by a clinician and subsequently measured with Goldmann applanation tonometry (GAT) by a different single masked clinician. RESULTS A total of 71 eyes of 71 children with known or suspected glaucoma were included. IOP by GAT ranged from 9 to 36 mm Hg. Icare readings ranged from 11 to 44 mm Hg. Mean difference between Icare and GAT was 2.3 ± SD 3.7 mm Hg, p < 0.0001. Icare IOPs were within ± 3 mm Hg of GAT in 63%. Icare IOPs were ≥GAT IOPs in 75%. The following factors were not associated with Icare IOPs greater than GAT: child's age, glaucoma diagnosis, strabismus, nystagmus, central corneal thickness, Icare instrument-reported reliability, number of glaucoma surgeries or medications, corneal abnormalities, and visual acuity. CONCLUSIONS IOP by Icare tonometry was within 3 mm Hg of IOP by GAT in 63% and greater than GAT in 75%. This device may be reasonable to estimate IOP in selected children with known or suspected glaucoma whose IOP cannot otherwise be obtained in clinic; however, correlation of Icare IOPs with clinical findings must continue to be considered in each case.
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Affiliation(s)
- Meghan S Flemmons
- Duke Eye Center, Durham, North Carolina; Wilford Hall Medical Center, Lackland Air Force Base, Texas, USA
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Abstract
PURPOSE The aim of this study was to assess the influence of the position (upright vs. supine) in the intraocular pressure (IOP) measured with a non-contact portable tonometer. METHODS Fifty university students with a mean age of 22.3±4.2 years (mean±SD) were recruited to participate in this study. IOP was measured with the non-contact tonometer Keeler, Pulsair EasyEye. Measurements in upright and supine positions were randomly obtained. In the upright position, 2 series of 3 measures (UP1 and UP2) and a series of 3 measures in the supine position were performed. RESULTS The values obtained in the positions UP1 and UP2 were compared, as well as the values of the upright and supine positions. No statistically significant differences were found when comparing the values obtained in the upright position (P>0.05). Instead, when the subjects were in the supine position, IOP increased 2.47±2.12 mm Hg (mean±SD), as opposed to the value obtained in the upright position (P<0.001). CONCLUSIONS Results from this study showed that IOP increased when measured in the supine position and that the Pulsair EasyEye tonometer can determine those variations in a healthy young population.
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Waisbourd M, Shemesh G, Top LB, Lazar M, Loewenstein A. Comparison of the Transpalpebral Tonometer TGDc-01 with Goldmann Applanation Tonometry. Eur J Ophthalmol 2010; 20:902-6. [DOI: 10.1177/112067211002000514] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Michael Waisbourd
- Department of Ophthalmology, Tel-Aviv Sourasky Medical Center, affiliated with the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv - Israel
| | - Gabi Shemesh
- Department of Ophthalmology, Tel-Aviv Sourasky Medical Center, affiliated with the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv - Israel
| | - Lea Baras Top
- Department of Ophthalmology, Tel-Aviv Sourasky Medical Center, affiliated with the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv - Israel
| | - Moshe Lazar
- Department of Ophthalmology, Tel-Aviv Sourasky Medical Center, affiliated with the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv - Israel
| | - Anat Loewenstein
- Department of Ophthalmology, Tel-Aviv Sourasky Medical Center, affiliated with the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv - Israel
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The influence of refractive errors on IOP measurement by rebound tonometry (ICare) and Goldmann applanation tonometry. Graefes Arch Clin Exp Ophthalmol 2009; 248:585-91. [PMID: 19727794 DOI: 10.1007/s00417-009-1176-5] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2009] [Revised: 08/01/2009] [Accepted: 08/05/2009] [Indexed: 10/20/2022] Open
Abstract
PURPOSE To evaluate the effect of refractive errors and central corneal thickness (CCT) on the measurement of intraocular pressure (IOP) by ICare rebound tonometer (RT), and its agreement with measurements by Goldmann applanation tonometer (GAT). PATIENTS AND METHODS Two observers measured the IOP by using RT and GAT in four groups of healthy volunteers with emmetropic (n = 78), hyperopic (n = 83), myopic (n = 87) and astigmatic (n = 79) eyes. Refraction was assessed by an autorefractometer. CCT was assessed by ultrasound pachymetry. RESULTS In all groups, no significant interobserver difference was seen in IOP values detected by both tonometers (Wilcoxon signed-rank test not significant). In all groups, IOP values were higher as measured by RT than by GAT (paired t-test p = 0.000): mean RT-GAT difference was higher in myopic eyes (+1.6 +/- 1.8 mmHg), and it was less than 1 mmHg in the other groups. RT-GAT difference was correlated to the refraction (p < 0.001), and it was greater when an higher IOP was detected by RT (significant correlation between RT-GAT difference and IOP by RT, p < 0.001). Compared with GAT values, the IOP readings by RT were greater than 2 mmHg in respectively 17.9% (emmetropic), 13.3% (hyperopic), 34.5% (myopic) and 7.6% (astigmatic) of the eyes. With both tonometers, in all groups the IOP values were correlated with CCT (p < 0.05), but the discrepancy between RT and GAT values was not related to CCT. CONCLUSIONS In all groups of subjects, higher IOP values were detected by RT; the IOP readings exceed the GAT values usually in a range of less than 1 mmHg, except when RT detects IOP >18 mmHg and generally in myopic eyes; RT-GAT discrepancy is related to the refractive error, but not to CCT.
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Rehnman JB, Martin L. Comparison of rebound and applanation tonometry in the management of patients treated for glaucoma or ocular hypertension. Ophthalmic Physiol Opt 2008; 28:382-6. [DOI: 10.1111/j.1475-1313.2008.00571.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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