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Chaung JQ, Sangapillai T, Quilat KK, Perera S. A comparison of intraocular pressure measurement using SUOER SW-500 rebound tonometer and conventional reusable Goldmann prisms. Front Med (Lausanne) 2024; 11:1269332. [PMID: 38938385 PMCID: PMC11208312 DOI: 10.3389/fmed.2024.1269332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Accepted: 06/03/2024] [Indexed: 06/29/2024] Open
Abstract
Introduction To determine the agreement between intraocular pressure (IOP) measurements using conventional Goldmann applanation tonometry (GA1,2T) and SUOER SW-500 Rebound Tonometer. Methods This was a retrospective observational study where 205 eyes of 106 glaucoma patients had their IOPs measured by 2 fellowship trained ophthalmologists. Data were analyzed using the Bland-Altman method of differences. Correlation was measured using the Pearson coefficient. Results Most of our patients were Chinese (88.7%) and female (51.9%). The average age was 66.9 years. The range of IOPs as measured by GAT was 2 to 58 mm Hg. Using the Bland-Altman method to compare GAT and SUOER SW-500 Rebound Tonometer. The tonometer overestimated the IOP by 0.5 mm Hg in the right eye and underestimated it by 0.1 mm Hg in the left eye. Overall, the tonometer overestimated the IOP by 0.2 mmHg. The Tonometer IOP correlated well with GAT, with a Pearson coefficient of correlation(r) of 0.89 (p < 0.001) for the right eye and 0.86 (p < 0.001) for the left eye, respectively. In patients with GAT IOP ≥ 21 mm Hg (n = 25), the Tonometer underestimated the IOP by 2.96 mm Hg. Discussion The IOP measurements from the SUOER SW-500 Rebound Tonometer correlates well with the conventional GAT in measuring the IOP within normal ranges of IOP. SUOER SW-500 Rebound Tonometer may be of use, especially if the risk of transmission of infection is high considering that the probes are disposable. It is easy to use and its small size and portability makes it useful in situations where the patient is unable to be examined at the slit lamp.
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Affiliation(s)
- Jia Quan Chaung
- Singapore National Eye Centre, Singapore, Singapore
- Singapore Eye Research Institute, Singapore, Singapore
| | | | | | - Shamira Perera
- Singapore National Eye Centre, Singapore, Singapore
- Singapore Eye Research Institute, Singapore, Singapore
- Duke-NUS Medical School, Singapore, Singapore
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2
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Wu THY, Lau HKC, Lai CHY, Wong RWL, Wong AKW, Lam AKC. Effect of digital ocular massage on intraocular pressure and Schlemm's canal dimensions. Sci Rep 2024; 14:6112. [PMID: 38480777 PMCID: PMC10937985 DOI: 10.1038/s41598-024-56748-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Accepted: 03/11/2024] [Indexed: 03/17/2024] Open
Abstract
Digital ocular massage has been reported to temporarily lower intraocular pressure (IOP). This could be related to an enhanced aqueous humor outflow; however, the mechanism is not clearly understood. Using anterior segment optical coherence tomography, the Schlemm's canal (SC) and trabecular meshwork (TM) can be imaged and measured. Here, 66 healthy adults underwent digital ocular massage for 10 min in their right eyes. The IOP and dimensions of the SC and TM were measured before and after ocular massage. All subjects demonstrated IOP reduction from 15.7 ± 2.5 mmHg at baseline to 9.6 ± 2.2 mmHg immediately after, and median of 11.6 mmHg 5-min after ocular massage (Friedman's test, p < 0.001). There was significant change in SC area (median 10,063.5 μm2 at baseline to median 10,151.0 μm2 after ocular massage, Wilcoxon test, p = 0.02), and TM thickness (median 149.8 μm at baseline to 144.6 ± 25.3 μm after ocular massage, Wilcoxon test, p = 0.036). One-third of the subjects demonstrated collapse of the SC area (-2 to -52%), while two-thirds showed expansion of the SC area (2 to 168%). There were no significant changes in SC diameter (270.4 ± 84.1 μm vs. 276.5 ± 68.7 μm, paired t-test, p = 0.499), and TM width (733.3 ± 110.1 μm vs. 733.5 ± 111.6 μm, paired t-test, p = 0.988). Eyes with a higher baseline IOP demonstrated a greater IOP reduction (Pearson correlation coefficient r = -0.521, p < 0.001). Eyes with smaller SC area at baseline showed greater SC area expansion (Pearson correlation coefficient = -0.389, p < 0.001). Greater IOP reduction appeared in eyes with greater SC area expansion (Pearson correlation coefficient r = -0.306, p = 0.01). Association between change in IOP and change in TM thickness was not significant (Spearman's ρ = 0.015, p = 0.902). Simple digital ocular massage is an effective method to lower IOP values, and change in the SC area was significantly associated with IOP changes.
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Affiliation(s)
- Tiffany H Y Wu
- School of Optometry, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
| | - Henry K C Lau
- School of Optometry, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
| | - Carmelo H Y Lai
- School of Optometry, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
| | - Ruby W L Wong
- School of Optometry, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
| | - Antonia K W Wong
- School of Optometry, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
| | - Andrew Kwok-Cheung Lam
- School of Optometry, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong.
- Research Centre for SHARP Vision, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong.
- Centre for Eye and Vision Research, 17W Hong Kong Science Park, Science Park, Hong Kong.
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Sachdeva R, Iordanous Y, Lin T. Comparison of intraocular pressure measured by iCare tonometers and Goldmann applanation tonometer. CANADIAN JOURNAL OF OPHTHALMOLOGY 2023; 58:426-432. [PMID: 35809628 DOI: 10.1016/j.jcjo.2022.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 05/31/2022] [Accepted: 06/07/2022] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To evaluate the relationship between the Goldmann applanation tonometer (GAT) and the iCare PRO and iCare IC200 tonometers in measuring intraocular pressure (IOP) in adult eyes with a diagnosis of glaucoma or glaucoma suspect. PARTICIPANTS AND METHODS One hundred and one eyes from 101 participants diagnosed with glaucoma or glaucoma suspect were evaluated in this study. IOP was measured by iCare PRO and iCare IC200 tonometers in a randomized sequence followed by IOP measurements by the GAT tonometer and then central corneal thickness measurements. After the IOP measurements, participants scored their comfort level using a visual analog scale with each tonometer. Intraclass correlation coefficient (ICC) and Bland-Altman analysis were used to investigate the agreement among tonometers. SPSS and Microsoft Excel programs were used for statistical analysis. RESULTS Overall, there was good agreement among the 3 tonometers used in this study. The ICC for the iCare PRO and the iCare IC200 was 0.95 (p < 0.001), and the ICC for the iCare PRO and the GAT and the iCare IC200 and the GAT was >0.80 (p < 0.001). However, both iCare tonometers underestimated IOP by approximately 2 mm Hg compared with the GAT. Furthermore, 84% of iCare readings fall within ±5 mm Hg of GAT measurements. Neither body mass index nor central corneal thickness affected the IOP agreement among the tonometers. Participant response on visual analog scale rated IOP measurements by iCare tonometers to be more comfortable than the GAT. CONCLUSION Our results demonstrated a good agreement between iCare tonometers and GAT; but iCare tonometers underestimated IOP compared to the GAT.
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Affiliation(s)
| | | | - Tony Lin
- Department of Ophthalmology, Western University, London, Ont
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Wongwanwatana S, Treesit I, Funarunart P, Iemsomboon W, Choontanom R. Intraocular pressure measurement using ICare rebound tonometer in different positions of eye and different locations on cornea. Medicine (Baltimore) 2023; 102:e34874. [PMID: 37682193 PMCID: PMC10489185 DOI: 10.1097/md.0000000000034874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 08/01/2023] [Indexed: 09/09/2023] Open
Abstract
Intraocular pressure (IOP) is one of the most crucial aspects for diagnosis and treatment plan among patients with glaucoma. Although the gold standard for IOP measurement is Goldmann applanation tonometer (GAT)[1], it must be mounted to a slit lamp biomicroscope. However, rebound tonometer has become popular due to its ease of operation and portable design, does not require topical anesthesia, and results do not differ significantly from those of GAT[2]. The purpose of this cross-sectional study is to investigate the difference in IOP measurement with iCare IC200 in different angles of the eye and different corneal locations. All participants underwent IOP measurement by GAT twice. Then, IOP was measured with iCare by a single physician. IOP was measured in a straight manner in the upright patient position; then participants were asked to look at fixation targets, which located in four different points. IOP was measured in upgaze, downgaze, medial gaze, and lateral gaze. Then, IOP was measured at 2 mm from limbus in superior, inferior, nasal, and temporal cornea. All methods were measured twice, and the mean was used for calculation. The physician who measured IOP by iCare was masked from GAT results. A total of 168 eyes were tested with a mean age of 62.15 ± 12.34 years. Mean IOP measured by GAT and iCare at the central cornea was 15.53 ± 5.57 and 14.78 ± 6.14 mmHg, respectively. The standardized mean difference (SMD) between iCare and GAT was 0.13 (-0.09-0.34), which is insignificant. The average IOP was 0.6, 0.47, 0.91, and 0.44 mmHg lower than the primary position in upgaze, downgaze, medial gaze, and lateral gaze 15 degrees angulated positions respectively (p<.01). IOPs at 2 mm from limbus in the inferior, nasal, and temporal cornea were 0.5, 0.69, and 0.57 mmHg lower than IOP measured at the central cornea (p=<.01). IOP measurements with iCare in different angles of eye were statistically significantly lower than in the primary position. Similarly, IOPs at different locations on cornea were lower than at the central cornea. However, the difference in IOP measurements with iCare in different angles of the eye and different corneal locations was in the trivial range and might be clinically insignificant.
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Affiliation(s)
- Sirada Wongwanwatana
- Department of Ophthalmology, Phramongkutklao Hospital, Phramongkutklao College of Medicine, Bangkok, Thailand
| | - Isaraporn Treesit
- Department of Ophthalmology, Phramongkutklao Hospital, Phramongkutklao College of Medicine, Bangkok, Thailand
| | - Panrapee Funarunart
- Department of Ophthalmology, Phramongkutklao Hospital, Phramongkutklao College of Medicine, Bangkok, Thailand
| | - Wallop Iemsomboon
- Department of Ophthalmology, Phramongkutklao Hospital, Phramongkutklao College of Medicine, Bangkok, Thailand
| | - Raveewan Choontanom
- Department of Ophthalmology, Phramongkutklao Hospital, Phramongkutklao College of Medicine, Bangkok, Thailand
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Vandeurzen J, Vansteelandt K, Lemmens S, Sienaert P. Lateralized Raise in Intraocular Pressure During Electroconvulsive Therapy: A Tonometry Pilot Study. J ECT 2023; 39:42-45. [PMID: 35969842 DOI: 10.1097/yct.0000000000000879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Right unilateral ECT causes an increase in eye pressure that is partially lateralized, higher on the right side.
Objective
The aim of this study was to evaluate intraocular pressure (IOP) changes during and after electroconvulsive therapy.
Methods
In 20 patients, IOP was measured using a handheld iCare tonometer before, during, and up to 15 minutes after the seizure. Electrode placement was either right unilateral (RUL) or bilateral (BL). Statistical analyses were done at baseline, during, and 15 minutes after the seizure.
Results
In the RUL group (n = 14), the IOP in the left eye increased from 14.8 mm Hg before the seizure to 27.8 mm Hg during the seizure (P = 0.0001) and decreased to 14.0 mm Hg after the seizure (P = 0.0002). The IOP in the right eye increased from 15.4 mm Hg before the seizure to 34.4 mm Hg during the seizure (P = 0.0001) and decreased to 16.0 mm Hg after the seizure (P = 0.0002).
In the BL group (n = 6), the IOP in the left eye increased from 13.0 mm Hg before the seizure to 26.3 mm Hg during the seizure (P = 0.1250) and decreased to 14.5 mm Hg after the seizure (P = 0.250). In the right eye, the IOP increased from 13.3 mm Hg before the seizure to 28.4 mm Hg during the seizure (P = 0.1250) and decreased to 13.7 mm Hg after the seizure (P = 0.25).
When the results were compared between the 2 electrode placements, the difference in IOP between the right and left eye was higher in the RUL group during (RUL 6.7 mm Hg vs BL 2.0 mm Hg, P = 0.0231) and after (RUL 2.1 mm Hg vs BL −0.8 mm Hg, P = 0.0492) the seizure.
Conclusions
RUL stimulation with electroconvulsive therapy causes a rise in IOP that is partially lateralized, ipsilateral to the side of stimulation.
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Affiliation(s)
| | - Kristof Vansteelandt
- KU Leuven, University Psychiatric Center KU Leuven, Academic Center for ECT and Neuromodulation
| | | | - Pascal Sienaert
- KU Leuven, University Psychiatric Center KU Leuven, Academic Center for ECT and Neuromodulation
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Influence of the body positions adopted for resistance training on intraocular pressure: a comparison between the supine and seated positions. Graefes Arch Clin Exp Ophthalmol 2023:10.1007/s00417-023-06009-0. [PMID: 36795163 DOI: 10.1007/s00417-023-06009-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 01/12/2023] [Accepted: 01/31/2023] [Indexed: 02/17/2023] Open
Abstract
OBJECTIVES A variety of factors are known to mediate on the intraocular pressure (IOP) response to resistance training. However, the influence of the body position adopted during resistance training on IOP remain unknown. The objective of this study was to determine the IOP response to the bench press exercise at three levels of intensity when performed in supine and seated positions. METHODS Twenty-three physically active healthy young adults (10 men and 13 women) performed 6 sets of 10 repetitions against the 10-RM (repetition maximum) load during the bench press exercise against three levels of intensity (high intensity: 10-RM load; medium intensity: 50% of the 10-RM load; and control: no external load) and while adopting two different body positions (supine and seated). A rebound tonometer was employed to measure IOP in baseline conditions (after 60 s in the corresponding body position), after each of the 10 repetitions, and after 10 s of recovery. RESULTS The body position adopted during the execution of the bench press exercise significantly affected the changes in IOP (p < 0.001, ηp2 = 0.83), with the seated position providing lower increases in IOP levels compared to the supine position. There was an association between IOP and exercise intensity, with greater IOP values in the more physically demanding conditions (p < 0.001, ηp2 = 0.80). CONCLUSIONS The use of seated positions, instead of supine positions, for the execution of resistance training should be prioritized for maintaining more stable IOP levels. This set of findings incorporates novel insights into the mediating factors on the IOP response to resistance training. In future studies, the inclusion of glaucoma patients would allow to assess the generalizability of these findings.
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Schornack MM, Vincent SJ, Walker MK. Anatomical and physiological considerations in scleral lens wear: Intraocular pressure. Cont Lens Anterior Eye 2023; 46:101535. [PMID: 34824016 DOI: 10.1016/j.clae.2021.101535] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 10/29/2021] [Accepted: 11/02/2021] [Indexed: 02/06/2023]
Abstract
Intraocular pressure (IOP) is maintained through complex and interrelated systems which control aqueous production and drainage, and it has been suggested that scleral lens (SL) wear may disrupt these vital homeostatic processes. This review provides an overview of anatomical and physiological processes that control IOP, identifies potential effects of SLs on these regulatory mechanisms, and examines studies that have attempted to quantify the effect of SLs on IOP. Lack of access to the cornea during SL wear makes accurate assessment of IOP challenging; therefore, a range of different assessment techniques and instruments have been employed to quantify IOP during and following SL wear. Some studies have evaluated IOP using standard techniques prior to lens application and following lens removal, or through a large central fenestration. Other studies have utilised instruments that facilitate assessment of IOP on the peripheral cornea or conjunctiva overlying the sclera (e.g. Schiotz, transpalpebral, and pneumatonometry). Two studies have recently evaluated changes in optic nerve structure during SL wear. Conflicting results have been reported on this topic, much of which examines changes in IOP in healthy subjects over limited periods of time. Currently, only a few studies have reported on long-term effects of SL wear on IOP in habitual SL wearers (after lens removal). Future research in this area must not only consider the fact that ocular conditions treated with SLs may potentially alter corneal biomechanical properties which can influence IOP, but also that these properties may be further altered by SL wear. Monitoring other risk factors for glaucoma (permanent alterations in optic nerve physiology, visual field defects) could provide a more comprehensive assessment of potentially increased risk of glaucomatous optic neuropathy due to SL wear. Ongoing clinical assessment of optic nerve structure and function is advisable in patients at risk for glaucoma who require SLs.
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Affiliation(s)
| | - Stephen J Vincent
- Queensland University of Technology (QUT), Centre for Vision and Eye Research, School of Optometry and Vision Science, Contact Lens and Visual Optics Laboratory, Queensland, Australia.
| | - Maria K Walker
- University of Houston College of Optometry, The Ocular Surface Institute, Houston, TX, USA.
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Agreement of iCare IC200 tonometry with Perkins applanation tonometry in healthy children. J AAPOS 2022; 26:235.e1-235.e5. [PMID: 36122876 DOI: 10.1016/j.jaapos.2022.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 07/05/2022] [Accepted: 07/16/2022] [Indexed: 11/21/2022]
Abstract
PURPOSE To assess interdevice agreement between the iCare IC200 rebound tonometer and Perkins applanation tonometry (gold standard) in a healthy pediatric population. METHODS A total of 42 eyes of 42 healthy children were assessed using both tonometers. Data was collected on subject's age, sex, best-corrected visual acuity, and central corneal thickness (CCT). Intraclass correlation coefficient (ICC) and Bland-Altman analyses were used to determine agreement between IC200 and Perkins applanation tonometers. Linear regression analyzed the effects of intraocular pressure (IOP) on device difference. RESULTS The mean age and standard deviation of healthy pediatric subjects was 10.0 ± 3.3 years. The mean difference between IC200 and Perkins tonometers (IC200-Perkins) was 0.72 mm Hg, with a mean of 17.1 ± 3.0 mm Hg and 16.4 ± 2.5 mm Hg, respectively. The absolute agreement, or ICC, between tonometers was 0.63 (95% CI, 0.56-0.70). Bland-Altman analysis showed 95% limits of agreement ranging from -5.2 to +6.6 mm Hg. CCT was not correlated with IOP for either the IC200 (P = 0.35) or the Perkins tonometer (P = 0.052). CONCLUSIONS Compared to applanation tonometry, IC200 overestimated IOP in healthy children, with a greater frequency of readings > +2 mm Hg than < -2 mm Hg compared to Perkins. There was moderate agreement between tonometers. CCT was not found to influence IOP measurement for either tonometer.
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Umfress AC, Glaser TS, Ploysangam P, Freedman SF. Rebound tonometry by iCare 200 (IC200): comparison with Tono-Pen in the operating room and Goldmann applanation in the clinic. J AAPOS 2021; 25:329.e1-329.e6. [PMID: 34737080 DOI: 10.1016/j.jaapos.2021.07.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 07/16/2021] [Accepted: 07/18/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Tonometry guides decision making in children with known or suspected glaucoma. The iCare IC200 is a recently FDA-approved rebound tonometer that can measure intraocular pressure (IOP) in both supine and upright patients. The purpose of this study was to evaluate this new tonometer against more commonly used standard instruments: Tono-Pen in the operating room (OR arm) and Goldmann applanation in the clinic (clinic arm). METHODS The OR arm included sequential children undergoing general anesthesia. The clinic arm included cooperative children seen in clinic. IOP was measured twice (right eye then left eye, repeat) with IC200 and either Tono-Pen (OR arm) or Goldmann (clinic arm). RESULTS A total of 99 children were included: 75 for the OR arm and 24 for the clinic arm. There was a strong correlation between the IOP measured by IC200 and each device (R2 = 0.81 for Tono-Pen; R2 = 0.78 for Goldmann). In the OR arm, the overall mean IOP difference (ΔIOP [Tono-Pen - IC200]) was -1.6 mm Hg. For eyes with corneal edema (n = 12), ΔIOP ranged from -8 to 15 mm Hg. At IOP >20 mm Hg, mean ΔIOP was -3.7 mm Hg. In the clinic arm, the mean ΔIOP (ΔIOP [Goldmann - IC200]) was -1.2 mm Hg. CONCLUSIONS In eyes of children under general anesthesia with IOP <20 mm Hg without corneal edema, IC200 and Tono-Pen correlated well. In cooperative clinic patients, Goldmann and IC200 correlated well over the range of IOP studied.
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Affiliation(s)
- Allison C Umfress
- Department of Ophthalmology, Duke University Medical Center, Durham, North Carolina
| | - Tanya S Glaser
- Department of Ophthalmology, Duke University Medical Center, Durham, North Carolina
| | - Pimpiroon Ploysangam
- Department of Ophthalmology, Duke University Medical Center, Durham, North Carolina
| | - Sharon F Freedman
- Department of Ophthalmology, Duke University Medical Center, Durham, North Carolina.
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Phu J, Masselos K, Kalloniatis M. Deployment of the Water Drinking Test and iCare HOME Phasing for Intraocular Pressure Profiling in Glaucoma Evaluation. Optom Vis Sci 2021; 98:1321-1331. [PMID: 34538849 DOI: 10.1097/opx.0000000000001806] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
SIGNIFICANCE Intraocular pressure (IOP) profiling is an important component of the glaucoma examination. Two techniques for profiling are the water drinking test (WDT) and iCare HOME phasing, but the correlations between techniques and their ease of deployment have not been studied. These questions are important in determining suitability for clinical deployment. PURPOSE This study aimed to compare the IOP results of the WDT and iCare HOME phasing in patients with suspected or newly diagnosed glaucoma. METHODS Ninety-eight consecutive patients attending a glaucoma clinic underwent IOP profiling using both techniques. For the WDT, patients ingested 10 mL/kg body weight of water after a baseline applanation IOP measurement and then underwent serial IOP measurements approximately every 15 minutes, ceasing after 30 minutes of consecutive measurements within 3 mmHg of baseline. Patients successfully certified for self-administration of the iCare HOME were loaned the instrument for 1 week and instructed to take four measurements per day. RESULTS Twenty-seven patients (28%) successfully obtained four measurements per day using iCare HOME, and 96 patients (98%) were able to complete the WDT. Intraocular pressure profiles showed no difference between the time for peak IOP and across nearly all IOP parameters obtained from profiling except for the standard deviation of IOP measurements obtained using the iCare HOME (P = .005). There were moderate correlations between peak IOPs obtained using each technique (r = 0.67, P = .001, right eye; r = 0.66, P = .002, left eye) but no correlation between the daily range (iCare HOME) or peak-trough difference (WDT; r = 0.21, P = .28, right eye; r = 0.27, P = .02, left eye). Bland-Altman analysis returned similar results for peak and range. CONCLUSIONS Intraocular pressure profiling using both techniques can reveal the peak IOP, and these measurements are strongly correlated. Most patients were unable to complete the iCare HOME according to the manufacturer's recommendations. Clinicians should select the most appropriate technique for each patient.
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Brusini P, Salvetat ML, Zeppieri M. How to Measure Intraocular Pressure: An Updated Review of Various Tonometers. J Clin Med 2021; 10:3860. [PMID: 34501306 PMCID: PMC8456330 DOI: 10.3390/jcm10173860] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 08/17/2021] [Accepted: 08/23/2021] [Indexed: 02/05/2023] Open
Abstract
Intraocular pressure (IOP) is an important measurement that needs to be taken during ophthalmic examinations, especially in ocular hypertension subjects, glaucoma patients and in patients with risk factors for developing glaucoma. The gold standard technique in measuring IOP is still Goldmann applanation tonometry (GAT); however, this procedure requires local anesthetics, can be difficult in patients with scarce compliance, surgical patients and children, and is influenced by several corneal parameters. Numerous tonometers have been proposed in the past to address the problems related to GAT. The authors review the various devices currently in use for the measurement of intraocular pressure (IOP), highlighting the main advantages and limits of the various tools. The continuous monitoring of IOP, which is still under evaluation, will be an important step for a more complete and reliable management of patients affected by glaucoma.
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Affiliation(s)
- Paolo Brusini
- Department of Ophthalmology, Policlinico “Città di Udine”, 33100 Udine, Italy;
| | - Maria Letizia Salvetat
- Department of Ophthalmology, Azienda Sanitaria Friuli Occidentale, 33170 Pordenone, Italy;
| | - Marco Zeppieri
- Department of Ophthalmology, University Hospital of Udine, 33100 Udine, Italy
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Wong SH, Tsai JC. Telehealth and Screening Strategies in the Diagnosis and Management of Glaucoma. J Clin Med 2021; 10:3452. [PMID: 34441748 PMCID: PMC8396962 DOI: 10.3390/jcm10163452] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 07/31/2021] [Accepted: 08/02/2021] [Indexed: 11/16/2022] Open
Abstract
Telehealth has become a viable option for glaucoma screening and glaucoma monitoring due to advances in technology. The ability to measure intraocular pressure without an anesthetic and to take optic nerve photographs without pharmacologic pupillary dilation using portable equipment have allowed glaucoma screening programs to generate enough data for assessment. At home, patients can perform visual acuity testing, web-based visual field testing, rebound tonometry, and video visits with the physician to monitor for glaucomatous progression. Artificial intelligence will enhance the accuracy of data interpretation and inspire confidence in popularizing telehealth for glaucoma.
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Affiliation(s)
- Sze H. Wong
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York Eye and Ear Infirmary of Mount Sinai, New York, NY 10003, USA;
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Nakakura S, Asaoka R, Terao E, Nagata Y, Fukuma Y, Oogi S, Shiraishi M, Kiuchi Y. Evaluation of rebound tonometer iCare IC200 as compared with IcarePRO and Goldmann applanation tonometer in patients with glaucoma. EYE AND VISION 2021; 8:25. [PMID: 34193284 PMCID: PMC8247177 DOI: 10.1186/s40662-021-00249-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 05/28/2021] [Indexed: 11/10/2022]
Abstract
Background This study investigated the agreement between a new rebound tonometer, IC200, and IcarePRO and Goldmann applanation tonometry (GAT). Methods This was a prospective cross-sectional study. We measured the intraocular pressure (IOP) in 145 eyes of 145 glaucoma patients in the sitting position using GAT, IcarePRO, and IC200. IcarePRO and IC200 measurements were also obtained in the supine position. IC200 measurement was performed using two modes: single six (IC200-single) and automatic (IC200-continuous) six-measurements mode. Results All tonometers provided high reproducibility in both positions (all intraclass correlation coefficients > 0.90), although it was highest with GAT, followed by IC200-continuous and IC200-single and then IcarePRO. In the sitting position, the mean (± SD) IOPs of GAT, IcarePRO, IC200-single, and IC200-continuous were 14.5 ± 2.9 mmHg, 13.3 ± 3.2 mmHg, 11.6 ± 3.2 mmHg, and 11.5 ± 3.2 mmHg, respectively. IOPs measured with IcarePRO or IC200 were significantly lower than those with GAT, particularly in patients with low IOP. IOPs measured with all tonometers were significantly elevated in the supine position as compared with the sitting position, but this difference was significantly greater with IC200-single and IC200-continuous compared with IcarePRO. IOP elevation was significant in eyes without bleb versus those with bleb, but this finding was not observed when IOP was measured with IcarePRO. The IOPs of the single and continuous modes of IC200 were interchangeable in both positions. Conclusions GAT, IcarePRO, and IC200 had sufficiently high reproducibility, but measurements with IcarePRO may not be accurate in the supine position. Elevation of IOP in the supine position, especially in eyes with bleb, was more sensitively captured with IC200 than with IcarePRO. Trial registration Japan Clinical Trials Register, No. UMIN000039982. Supplementary Information The online version contains supplementary material available at 10.1186/s40662-021-00249-z.
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Affiliation(s)
- Shunsuke Nakakura
- Department of Ophthalmology, Saneikai Tsukazaki Hospital, 68-1 Aboshi Waku, Himeji, 671-1227, Japan.
| | - Ryo Asaoka
- Department of Ophthalmology, Seirei Hamamatsu General Hospital, Hamamatsu, Shizuoka, Japan. .,Seirei Christopher University, Hamamatsu, Shizuoka, Japan.
| | - Etsuko Terao
- Department of Ophthalmology, Saneikai Tsukazaki Hospital, 68-1 Aboshi Waku, Himeji, 671-1227, Japan
| | - Yuki Nagata
- Department of Ophthalmology, Saneikai Tsukazaki Hospital, 68-1 Aboshi Waku, Himeji, 671-1227, Japan
| | - Yasuko Fukuma
- Department of Ophthalmology, Saneikai Tsukazaki Hospital, 68-1 Aboshi Waku, Himeji, 671-1227, Japan
| | - Satomi Oogi
- Department of Ophthalmology, Saneikai Tsukazaki Hospital, 68-1 Aboshi Waku, Himeji, 671-1227, Japan
| | - Miku Shiraishi
- Department of Ophthalmology, Saneikai Tsukazaki Hospital, 68-1 Aboshi Waku, Himeji, 671-1227, Japan
| | - Yoshiaki Kiuchi
- Department of Ophthalmology and Visual Sciences, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan
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Lee JU, Park KS, Kim J, Lee SB, Lee YH, Kim KN. Usefulness of the Icare ic200 Rebound Tonometer in Korean. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2021. [DOI: 10.3341/jkos.2021.62.5.665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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15
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Janicijevic D, Redondo B, Jiménez R, Lacorzana J, García-Ramos A, Vera J. Intraocular pressure responses to walking with surgical and FFP2/N95 face masks in primary open-angle glaucoma patients. Graefes Arch Clin Exp Ophthalmol 2021; 259:2373-2378. [PMID: 33825030 PMCID: PMC8023773 DOI: 10.1007/s00417-021-05159-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 03/03/2021] [Accepted: 03/10/2021] [Indexed: 01/04/2023] Open
Abstract
Purpose The use of face mask is globally recommended as a preventive measure against COVID-19. However, the intraocular pressure (IOP) changes caused by face masks remain unknown. The objective of this study was to assess the impact of wearing surgical and FFP2/N95 face masks during a 400-m walking protocol on IOP in primary open-angle glaucoma (POAG) patients. Methods Thirteen subjects diagnosed of POAG (21 eyes) were enrolled in this study. IOP was measured at baseline, during the 400-m walking protocol and after 5 min of passive recovery while POAG patients wore a surgical mask, FFP2/N95 mask and no mask in randomized order. From the 21 POAG eyes, we analyzed the IOP changes caused by physical exercise with two face masks and without wearing any face mask. Results At rest (baseline and recovery measurements), the use of the different face masks did not affect IOP levels (mean differences ranging from 0.1 to 0.6 mmHg). During physical activity, wearing an FFP2/N95 mask caused a small (mean differences ranging from 1 to 2 mmHg), but statistically significant, IOP rise in comparison to both the surgical mask and control conditions (Cohen’s d = 0.63 and 0.83, respectively). Conclusion Face masks must be used to minimize the risk of SARS-CoV-2 transmission, and POAG patients can safely use FFP2/N95 and surgical masks at rest. However, due to the IOP rise observed while walking with the FFP2/N95 mask, when possible, POAG patients should prioritized the use of surgical masks during physical activity.
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Affiliation(s)
- Danica Janicijevic
- Research Academy of Human Biomechanics, The Affiliated Hospital of Medical School of Ningbo University, Ningbo University, Ningbo, China.,Faculty of Sports Science, Ningbo University, Ningbo, China.,Faculty of Sport and Physical Education, The Research Centre, University of Belgrade, Belgrade, Serbia
| | - Beatríz Redondo
- CLARO (Clinical and Laboratory Applications of Research in Optometry) Research Group, Department of Optics, Faculty of Sciences, University of Granada, Campus de la Fuentenueva 2, 18001, Granada, Spain.
| | - Raimundo Jiménez
- CLARO (Clinical and Laboratory Applications of Research in Optometry) Research Group, Department of Optics, Faculty of Sciences, University of Granada, Campus de la Fuentenueva 2, 18001, Granada, Spain
| | - Javier Lacorzana
- Department of Ophthalmology, Virgen de las Nieves University Hospital, Granada, Spain
| | - Amador García-Ramos
- Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain.,Department of Sports Sciences and Physical Conditioning, Faculty of Education, Catholic University of the Most Holy Conception, Concepción, Chile
| | - Jesús Vera
- CLARO (Clinical and Laboratory Applications of Research in Optometry) Research Group, Department of Optics, Faculty of Sciences, University of Granada, Campus de la Fuentenueva 2, 18001, Granada, Spain
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