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Qin B, Li LP, Xu QD, Lei Y, Chen YH. Identification of a circulating three-miRNA panel for the diagnosis of primary open angle glaucoma. Int Ophthalmol 2024; 44:176. [PMID: 38619629 DOI: 10.1007/s10792-024-03100-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 03/24/2024] [Indexed: 04/16/2024]
Abstract
PURPOSE Conventional diagnosis of primary open angle glaucoma (POAG) needs a combination of ophthalmic examinations. An efficient assay is urgently needed for a timely POAG diagnosis. We aim to explore differential expressions of circulating microRNAs (miRNA) and provide novel miRNA biomarkers for POAG diagnosis. METHODS A total of 180 POAG patients and 210 age-related cataract (ARC) patients were enrolled. We collected aqueous humor (AH) and plasma samples from the recruited patients. The expressions of candidate miRNAs were measured using quantitative real time polymerase chain reaction. The diagnostic ability of candidate miRNAs was analyzed by receiver operating characteristic curve. RESULTS The expressions of miR-21-5p and miR-29b-3p were downregulated significantly in AH and plasma of POAG and miR-24-3p expression was significantly increased in AH and plasma of POAG, comparing with those of ARC. A three-miRNA panel was constructed by a binary logistic regression. And the panel could differentiate between POAG and ARC with an area under the curve of 0.8867 (sensitivity = 78.0%, specificity = 83.3%) in aqueous humor and 0.7547 (sensitivity = 73.8%, specificity = 81.2%) in plasma. Next, we verified the three-miRNA panel working as a potential diagnostic biomarker stable and reliable. At last, we identified related function and regulation pathways in vitro. CONCLUSIONS In conclusion, we built and identified a circulating three-miRNA panel as a potential diagnostic biomarker for POAG. It may be developed into an efficient assay and help improve the POAG diagnosis in the future.
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Affiliation(s)
- Bo Qin
- Department of Ophthalmology & Visual Science, Eye & ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, 200031, China
| | - Li-Ping Li
- Department of Ophthalmology & Visual Science, Eye & ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, 200031, China
| | - Qing-Dan Xu
- Department of Ophthalmology & Visual Science, Eye & ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, 200031, China
| | - Yuan Lei
- Department of Ophthalmology & Visual Science, Eye & ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, 200031, China.
- Key Laboratory of Myopia, Chinese Academy of Medical Sciences (Fudan University), and Shanghai Key Laboratory of Visual Impairment and Restoration (Fudan University), Shanghai, 200031, China.
| | - Yu-Hong Chen
- Department of Ophthalmology & Visual Science, Eye & ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, 200031, China.
- Key Laboratory of Myopia, Chinese Academy of Medical Sciences (Fudan University), and Shanghai Key Laboratory of Visual Impairment and Restoration (Fudan University), Shanghai, 200031, China.
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Accuracy and reliability of measurements obtained with a noncontact tono-pachymeter for clinical use in mass screening. Sci Rep 2021; 11:8900. [PMID: 33903678 PMCID: PMC8076298 DOI: 10.1038/s41598-021-88364-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 04/12/2021] [Indexed: 11/09/2022] Open
Abstract
We evaluated the reliability and accuracy of the noncontact CT-1P tonopachymeter (Topcon, Japan) in terms of intraocular pressure (IOP) and central corneal thickness (CCT). One hundred sixty-three healthy participants and 33 patients with open angle glaucoma were enrolled. IOPs were measured by CT-1P (T-IOP) and Goldmann applanation tonometer (G-IOP), and CCTs were measured by the CT-1P (T-CCT) and an ultrasound pachymeter (US-CCT). Both CCT instrument-adjusted (T-IOP-C) and unadjusted T-IOPs (T-IOP-NC) were included. Pearson correlation coefficients and biases assessed with Bland-Altman analysis with 95% confidence interval (CI) were calculated for reliability evaluation. Intrasession repeatability was excellent for both T-IOP (intraclass correlation coefficient [ICC] 0.91) and T-CCT (ICC 0.98). Intersession reproducibility was also excellent for T-CCT (ICC 0.94). T-IOP-NC and T-IOP-C both showed significant correlations with G-IOP (r = 0.801, P < 0.001 and r = 0.658, P < 0.001, respectively). T-CCT was also strongly correlated with US-CCT (r = 0.958; P < 0.001). T-IOP-NC and T-IOP-C both showed a positive bias (1.37 mmHg, 95% CI [1.14, 1.61] and 2.77 mmHg, 95% CI [2.49, 3.05], respectively). T-CCT showed a negative bias of - 17.3 µm (95% CI [-18.8, - 15.8]). With cautious interpretation, the CT-1P may offer good feasibility for IOP and CCT measurement in screening centers.
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Nakao Y, Kiuchi Y, Okumichi H. Evaluation of biomechanically corrected intraocular pressure using Corvis ST and comparison of the Corvis ST, noncontact tonometer, and Goldmann applanation tonometer in patients with glaucoma. PLoS One 2020; 15:e0238395. [PMID: 32966284 PMCID: PMC7510959 DOI: 10.1371/journal.pone.0238395] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Accepted: 08/15/2020] [Indexed: 11/29/2022] Open
Abstract
Purpose The aim of the study was to investigate the effects of various anatomical structures on intraocular pressure (IOP) measurements obtained by the Corneal Visualization Scheimpflug Technology (Corvis ST), Goldmann applanation tonometer (GAT), and noncontact tonometer (NCT), as well as to assess the interchangeability among the four types of IOP measurement: IOP-GAT, IOP-NCT, IOP-Corvis, and biomechanically corrected IOP (bIOP-Corvis), with a particular focus on bIOP-Corvis. Materials and methods We included 71 patients with primary open-angle glaucoma and assessed their IOP measurements obtained with the GAT, NCT, and Corvis ST using a repeated measures ANOVA, a paired t-test with Bonferroni correction, stepwise multiple regression analyses and Bland–Altman plots. Results IOP-GAT showed the highest values (13.5 ± 2.1 mmHg [mean ± standard deviation]), followed by IOP-NCT (13.2 ± 2.7 mmHg), IOP-Corvis (10.6 ± 2.8 mmHg), and bIOP-Corvis (10.0 ± 2.3 mmHg). With exceptions of bIOP-Corvis and IOP-GAT, all IOP variations were explained by regression coefficients involving the central corneal thickness. Bland–Altman plots showed a mean difference between IOP-GAT and the other IOP measurements (IOP-Corvis, bIOP-Corvis, and IOP-NCT), which were -2.90, -3.48, and -0.29 mmHg, respectively. The widths of the 95% limits of agreement between all pairs of IOP measurements were greater than 3 mmHg. Conclusion IOP values obtained with the Corvis ST, NCT, and GAT were not interchangeable. The bIOP-Corvis measurement corrected for the ocular structure.
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Affiliation(s)
- Yoshitaka Nakao
- Ophthalmology and Visual Science Department, Hiroshima University, Hiroshima, Japan
- * E-mail:
| | - Yoshiaki Kiuchi
- Ophthalmology and Visual Science Department, Hiroshima University, Hiroshima, Japan
| | - Hideaki Okumichi
- Ophthalmology and Visual Science Department, Hiroshima University, Hiroshima, Japan
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Velis G, Kavitha S, Zebardast N, Sengupta S, Venkatesh R. Comparison of the corrected intraocular pressure by tonopachy with that of Goldmann applanation tonometry in normal and glaucomatous patients. Indian J Ophthalmol 2020; 68:620-626. [PMID: 32174582 PMCID: PMC7210839 DOI: 10.4103/ijo.ijo_570_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Purpose: To compare corrected intraocular pressure (IOP) by tonopachy with that of Goldmann applanation tonometry (GAT) in normal and glaucomatous patients. Methods: In this cross-sectional study, IOP and central corneal thickness (CCT) were measured in 426 eyes (213 normal eyes and 213 glaucomatous eyes) of 426 patients by tonopachy followed by GAT and ultrasound pachymetry. IOP was corrected for CCT by in-built formula in tonopachy and Ehlers correction factor for Goldmann tonometer. Limits of agreements were assessed using Bland–Altman plots. Intraclass correlation coefficient was calculated to estimate the absolute agreement between single and average measurements of IOP and CCT of tonopachy with that of Goldmann tonometer and ultrasound pachymetry respectively. Results: Mean corrected IOP measured with tonopachy and GAT in glaucomatous eyes was 17.63 ± 5.04 mmHg and 19.42 ± 5.83 mmHg, and in controls it was 13.4 ± 2.5 mmHg and 16.2 ± 3.1 mmHg, respectively. Limits of agreement ranged from –4.63 to +9.25 mmHg for total population (mean = 2.31), ˗6.01 to +9.59 mmHg (mean = 1.79) for glaucoma group and ˗2.99 to +8.65 mmHg (mean = 2.83) for controls. Intraclass correlation coefficient for IOP measurement between tonopachy and Goldmann tonometer was 0.84 for total population, 0.85 for glaucoma group, and 0.63 for controls, respectively. Conclusion: Corrected IOP obtained by tonopachy showed moderate agreement with GAT and it is more in glaucoma patients than controls. Thus, tonopachy can be used as a screening tool, but cannot replace GAT.
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Affiliation(s)
- Girish Velis
- Department of Glaucoma, Aravind Eye Hospital, Pondicherry, India
| | | | - Nazlee Zebardast
- Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA
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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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Tonometers-which one should I use? Eye (Lond) 2018; 32:931-937. [PMID: 29456251 DOI: 10.1038/s41433-018-0040-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Revised: 01/22/2018] [Accepted: 01/25/2018] [Indexed: 11/08/2022] Open
Abstract
Although several factors are known to play a role in the development and progression of glaucoma, intraocular pressure (IOP) remains the only modifiable risk factor. Medical and surgical treatments for glaucoma both aim to reduce IOP to minimize disease progression. Tonometry is therefore an essential element of the ophthalmological exam. There are several types of tonometers available currently. These range from well-established instruments that have been in clinical use for decades to new devices, which are the result of recent technological advances. The various instruments have advantages and disadvantages that affect their suitability for a given setting, purpose, and patient population. In this review, we aim to describe the most commonly available tonometers today along with their advantages, disadvantages, and applicability.
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Bang SP, Lee CE, Kim YC. Comparison of intraocular pressure as measured by three different non-contact tonometers and goldmann applanation tonometer for non-glaucomatous subjects. BMC Ophthalmol 2017; 17:199. [PMID: 29096616 PMCID: PMC5668971 DOI: 10.1186/s12886-017-0593-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Accepted: 10/27/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To compare the measurement of intraocular pressure (IOP) among the three different non-contact tonometers (NCT) and the Goldmann applanation tonometer (GAT) for non-glaucomatous subjects. METHODS In 52 eyes of 52 non-glaucomatous subjects, IOP was measured sequentially with the Canon TX-20P, the Nidek NT-530P, the Topcon CT-1P, and the GAT at the same time. We evaluated the IOP-measurement agreement among the tonometers as well as the factors affecting the measurements. RESULTS A significant positive correlation was shown between the IOP values obtained with GAT and each NCT. The Canon TX-20P showed statistically the most significant agreement with the GAT (ICC 0.906, 95% CI 0.837-0.946). In an analysis of the Bland-Altman plots, the Canon TX-20P also showed the largest mean bias (1.38 mmHg) but the narrowest limits of agreement (LoA) (95% LoA; ± 3.43 mmHg). The Topcon CT-1P showed the smallest mean bias (0.48 mmHg) but the widest LoA (95% LoA; ± 4.16 mmHg). The Topcon CT-1P and Nidek NT-530P both showed a significantly positive correlation between increasing central corneal thickness (CCT) and increasing IOP. CONCLUSION There was a statistically significant correlation between each of the three different NCT and the GAT measurements. IOP measured with the Canon TX-20P and Topcon CT-1P tended to be higher, and with the Nidek NT-530P lower, than with the GAT. Practitioners need to know the properties of their own NCTs and their respective measurement tendencies.
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Affiliation(s)
- Seung Pil Bang
- Department of Ophthalmology, Keimyung University School of Medicine, Dongsan Medical Center, #56, Dalseong-ro, Jung-gu, Daegu, 41931, South Korea
| | - Chong Eun Lee
- Department of Ophthalmology, Keimyung University School of Medicine, Dongsan Medical Center, #56, Dalseong-ro, Jung-gu, Daegu, 41931, South Korea
| | - Yu Cheol Kim
- Department of Ophthalmology, Keimyung University School of Medicine, Dongsan Medical Center, #56, Dalseong-ro, Jung-gu, Daegu, 41931, South Korea.
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Mansoori T, Balakrishna N. Effect of central corneal thickness on intraocular pressure and comparison of Topcon CT-80 non-contact tonometry with Goldmann applanation tonometry. Clin Exp Optom 2017; 101:206-212. [PMID: 29044716 DOI: 10.1111/cxo.12620] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Revised: 05/19/2017] [Accepted: 06/19/2017] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND To compare intraocular pressure (IOP) measurements obtained with the Topcon CT-80 non-contact tonometer (NCT) and Goldmann applanation tonometer (GAT), in different ranges of IOP in normal and glaucoma subjects, and to assess the influence of central corneal thickness (CCT) on the IOP measurements in Asian Indian eyes. METHODS Four hundred and two eyes of 402 subjects (193 newly diagnosed primary open angle glaucoma [POAG] and 209 normal) were enrolled for this prospective study. For each eye, IOP was measured with GAT by a glaucoma specialist and NCT by a trained optometrist. The IOP values were compared among the tonometers in the three different IOP ranges (≤ 12 mmHg, 13-20 mmHg and ≥ 21 mmHg) using Bland-Altman graphs. Correlation between GAT and NCT was assessed by Pearson correlation co-efficient. CCT was measured with ultrasound pachymetry and its correlation with GAT and NCT was analysed using linear regression analysis. RESULTS The mean paired difference of IOP between NCT and GAT was 1.556 ± 2.69 mmHg (r = 0.26, p = 0.006) at IOP range of ≤ 12 mmHg, -1.665 ± 2.6 mmHg (r = 0.51, p < 0.0001) in IOP range of 13-20 mmHg and -2.202 ± 3.44 mmHg (r = 0.82, p < 0.0001) in the IOP range of ≥ 21 mmHg. Linear regression analysis showed a mean IOP variation of 0.27 mmHg per 10 μm change in CCT for NCT (p < 0.0001) and IOP change of 0.19 mmHg per 10 μm change in CCT for GAT (p = 0.01). CONCLUSION In this study of normotensive and POAG subjects, the Topcon CT-80 NCT showed an overestimation of IOP at the lower range and underestimation of IOP in normal and higher ranges of IOP. Clinicians should keep in mind that CCT influences IOP measurement with both types of tonometer and that the IOP readings obtained with these tonometers are not interchangeable.
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Jethani J, Dave P, Jethani M, Desai Y, Patel P. The applicability of correction factor for corneal thickness on non-contact tonometer measured intraocular pressure in LASIK treated eyes. Saudi J Ophthalmol 2016; 30:25-8. [PMID: 26949354 PMCID: PMC4759510 DOI: 10.1016/j.sjopt.2015.11.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2015] [Revised: 10/22/2015] [Accepted: 11/11/2015] [Indexed: 12/03/2022] Open
Abstract
Purpose To determine the applicability of central corneal thickness (CCT) based correction factor for non-contact tonometer (NCT) measured intraocular pressure (IOP) readings. Method A prospective, non-randomized study involved 346 eyes of 173 consecutive patients with age ⩾21 years undergoing laser-assisted in situ keratomileusis (LASIK) for myopia and/or myopic astigmatism. The CCT and IOP were measured before and after the LASIK procedure. The IOP pre and post-LASIK was compared after applying the correction factor for CCT. Patients not completing the 3 month postoperative follow-up were excluded. Results The median spherical equivalent before undergoing LASIK was −4.25D (inter-quartile range, −3.25D). The mean preoperative CCT was 536.82 ± 33.71 μm which reduced to 477.55 ± 39.3 μm (p < 0.01) post-LASIK. The mean IOP reduced from a preoperative value of 14.6 ± 2.32 mmHg to 10.64 ± 2.45 mmHg postoperatively (p < 0.01). On applying correction for the corneal thickness, the pre and postoperative IOP was 15.14 ± 2.8 mmHg and 15.37 ± 2.65 mmHg (p = 0.06) respectively with a strong positive correlation (r = 0.7, p < 0.01). Three hundred eyes (86.7%) had an absolute difference in IOP of less than 3.0 mmHg post-CCT correction which is within the retest variability of NCT. Only 46 eyes (13.3%) had an absolute difference of more than 3.0 mmHg. Conclusion The modified Ehler’s correction algorithm used in this study can be effectively applied in the normal IOP range in a majority of patients.
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Affiliation(s)
- Jitendra Jethani
- Dr. T V Patel Eye Institute, Vadodara 390001, India; Surat Eye Laser Centre, Adarsh Society, Athwa, Surat 395001, India
| | - Paaraj Dave
- Dr. T V Patel Eye Institute, Vadodara 390001, India
| | - Monica Jethani
- Surat Eye Laser Centre, Adarsh Society, Athwa, Surat 395001, India
| | - Yogesh Desai
- Surat Eye Laser Centre, Adarsh Society, Athwa, Surat 395001, India
| | - Purvi Patel
- Surat Eye Laser Centre, Adarsh Society, Athwa, Surat 395001, India
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Nuyen B, Mansouri K. Detecting IOP Fluctuations in Glaucoma Patients. Open Ophthalmol J 2016; 10:44-55. [PMID: 27014387 PMCID: PMC4780505 DOI: 10.2174/1874364101610010044] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2015] [Revised: 08/18/2015] [Accepted: 08/18/2015] [Indexed: 11/12/2022] Open
Abstract
Lowering intraocular pressure (IOP) remains the guiding principle of glaucoma management. Although IOP is the only treatable risk factor, its 24-hour behavior is poorly understood. Current glaucoma management usually relies on single IOP measurements during clinic hours, even though IOP is a dynamic parameter with rhythms dependent on individual patients. It has further been shown that most glaucoma patients have their highest IOP measurements outside clinic hours. The fact that these IOP peaks go largely undetected may explain why certain patients progress in their disease despite treatment. Nevertheless, single IOP measurements have determined all major clinical guidelines regarding glaucoma treatment. Other potentially informative parameters, such as fluctuations in IOP and peak IOP, have been neglected, and effects of IOP-lowering interventions on such measures are largely unknown. Continuous 24-hour IOP monitoring has been an interest for more than 50 years, but only recent technological advances have provided clinicians with a device for such an endeavor. This review discusses current uses and shortcomings of current measurement techniques, and provides an overview on current and future methods for 24-hour IOP assessment. It may be possible to incorporate continuous IOP monitoring into clinical practice, potentially to reduce glaucoma-related vision loss.
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Affiliation(s)
- Brenda Nuyen
- Hamilton Glaucoma Center and Department of Ophthalmology, University of California, San Diego, La Jolla, California, USA
| | - Kaweh Mansouri
- Glaucoma Center, Montchoisi Clinic, Genolier Swiss Vision Network, Lausanne, Switzerland
- Department of Ophthalmology, University of Colorado School of Medicine, Aurora, Colorado, USA
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Comparison of Intraocular Pressure Measurements Between Goldmann Applanation Tonometry and Reichert 7 Noncontact Tonometry. J Glaucoma 2015; 24:438-41. [DOI: 10.1097/ijg.0000000000000009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Abstract
According to the World Health Organization, glaucoma is the leading cause of irreversible blindness worldwide. Although intraocular pressure (IOP) is not considered any more to be a defining feature of the disease, its lowering remains the only treatment option for glaucoma. Therefore, accurate and precise measurement of IOP is the cornerstone of glaucoma. Intraocular pressure is a highly dynamic physiological parameter with individual circadian rhythms. The main limitation of current tonometry methods remains the static and mostly office-based nature of their measurements. This review provides a brief historical overview on tonometry and discusses current tonometry instruments. In recent years, approaches to 24-hour IOP monitoring have been introduced, and there is hope that they may become part of routine clinical management in the future.
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Affiliation(s)
- Brenda Nuyen
- From the *Hamilton Glaucoma Center and the Department of Ophthalmology, University of California, San Diego, La Jolla, CA; †Glaucoma Sector, Department of Ophthalmology, Geneva University Hospitals, Geneva, Switzerland; and ‡Department of Ophthalmology, University of Colorado School of Medicine, Denver, CO
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Comparison of Intraocular Pressure Measurements With the Reichert Pt100, the Keeler Pulsair Intellipuff Portable Noncontact Tonometers, and Goldmann Applanation Tonometry. J Glaucoma 2015; 24:356-63. [DOI: 10.1097/01.ijg.0000435776.99193.41] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Rimayanti U, Kiuchi Y, Uemura S, Takenaka J, Mochizuki H, Kaneko M. Ocular surface displacement with and without contact lenses during non-contact tonometry. PLoS One 2014; 9:e96066. [PMID: 24781212 PMCID: PMC4004546 DOI: 10.1371/journal.pone.0096066] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2013] [Accepted: 04/03/2014] [Indexed: 11/18/2022] Open
Abstract
PURPOSE To evaluate the displacement of the central ocular surface during non-contact tonometry with and without soft contact lenses and determine the factors associated with the displacement of the central ocular surface and intraocular pressure (IOP) reading changes caused by wearing soft contact lenses (CLs). METHODS One eye each in 21 subjects was studied. The cornea was photographed using a high-speed camera at 5,000 frames/sec during non-contact tonometry without contact lenses (NCL), with -5.0 diopters (D), -0.5 D and +5.0 D CL. The displacement of the ocular surface and the factors affecting displacement at the IOP reading and maximum displacement time were investigated. RESULTS The IOP readings while wearing +5 D CL were significantly higher than those obtained while wearing -5 D CL. The ocular surface displacement between +5 D CL and other groups were significantly different. A significant positive correlation was found between the ocular surface displacement of subjects at the IOP reading time and the IOP obtained with the non-contact tonometer. A significant negative correlation was found between the ocular surface curvature and the IOP obtained using the non-contact tonometer. The radius of curvature of the ocular surface affected the displacement during the IOP reading and maximum displacement time. CONCLUSIONS Our results indicate that soft contact lens use changes the ocular surface behavior and IOP readings during non-contact tonometry. The radius of curvature of the eye affects the ocular surface displacement and IOP readings in this situation.
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Affiliation(s)
- Ulfah Rimayanti
- Department of Ophthalmology and Visual Science, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan
- * E-mail:
| | - Yoshiaki Kiuchi
- Department of Ophthalmology and Visual Science, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan
| | - Shohei Uemura
- Department of Mechanical Engineering, Graduate School of Engineering, Osaka University, Osaka, Japan
| | - Joji Takenaka
- Department of Ophthalmology and Visual Science, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan
| | - Hideki Mochizuki
- Department of Ophthalmology and Visual Science, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan
| | - Makoto Kaneko
- Department of Mechanical Engineering, Graduate School of Engineering, Osaka University, Osaka, Japan
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García-Resúa C, Pena-Verdeal H, Miñones M, Giraldez MJ, Yebra-Pimentel E. Reliability of the non-contact tono-pachymeter Tonopachy NT-530P in healthy eyes. Clin Exp Optom 2013; 96:286-94. [PMID: 23414260 DOI: 10.1111/j.1444-0938.2012.00818.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Non-contact Tonopachy NT-530P (Nidek Co., LTD) provides intraocular pressure (IOP) and central corneal thickness (CCT) measurements. This study assesses the reliability and repeatability of its IOP measurements in young healthy adult subjects. METHODS IOP was determined in the right eye of 64 healthy patients using Tonopachy followed by the Canon TX-10 non-contact and Goldmann applanation (GAT) tonometers. Tonopachy IOP measurements were corrected (Tonopachy-C) or not (Tonopachy-NC) by the instrument for central corneal thickness. Central corneal thickness measurements provided by Tonopachy were also used to correlate (Pearson's coefficient) central corneal thickness with the GAT and Canon TX-10 IOPs. Repeatability of Tonopachy and GAT was assessed in the right eye of 31 subjects in two separate sessions one week apart. Differences between pairs of instruments and between sessions were determined using Bland-Altman plots. The coefficient of repeatability was calculated as the 95% limits of agreement (LoA) of differences between the two sessions. RESULTS Tonopachy-NC, Tonopachy-C, Canon TX-10 and the Goldmann tonometers showed a mean IOP of 14.62, 15.64, 15.02 and 14.68 mmHg, respectively. Tonopachy-NC and Canon TX-10 readings did not differ significantly from the Goldmann (p > 0.05), with close agreement with both tonometers (GAT versus Tonopachy-NC: -3.84 to 3.96 mmHg; Goldmann versus Canon TX-10: -4.75 to 4.07 mmHg). Tonopachy-C readings differed significantly from Goldmann (mean difference -0.96 mmHg, p = 0.001, LoA from -5.09 to 3.17). Coefficients of repeatability were ± 3.70, ± 3.14 and ± 3.33 mmHg for GAT, Tonopachy-NC and Tonopachy-C, respectively. Central corneal thickness measured with Tonopachy was 530.42 ± 34.96 μm. There was a significant correlation between central corneal thickness and IOP for all tonometers except Tonopachy-C. CONCLUSIONS Reasonable agreement was observed between the Goldmann and Tonopachy. This instrument provides reliable and repeatable IOP measurements not influenced by central corneal thickness. The Tonopachy-NC and Canon TX-10 offer similar reliability compared to the Goldmann applanation tonometer in a young normotensive population.
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Affiliation(s)
- Carlos García-Resúa
- Department of Applied Physics (Optometry Group), Universidad de Santiago de Compostela, Santiago de Compostela, Spain
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Ogbuehi KC, Mucke S, Osuagwu UL. Influence of central corneal thickness on measured intraocular pressure differentials: Nidek RKT-7700, Topcon CT-80 NCTs and Goldmann Tonometer. Ophthalmic Physiol Opt 2012; 32:547-55. [PMID: 23009324 DOI: 10.1111/j.1475-1313.2012.00945.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2012] [Accepted: 08/31/2012] [Indexed: 11/26/2022]
Abstract
PURPOSE We sought to compare the intraocular pressure (IOP) measured by RKT-7700 and CT-80 noncontact tonometers (NCTs) with that measured by Goldmann applanation tonometry (GAT). We also examined the influence of central corneal thickness (CCT) on the agreement between both NCTs and GAT in a sub-population of healthy, young normals. METHODS Triplicate IOP and CCT measurements were obtained twice from one randomized eye of 49 subjects (28 males and 21 females) aged 22.2 ± 1.3 (mean ± S.D.) years. Goldmann tonometry was performed subsequent to assessment with the RKT-7700 and CT-80, to negate the 'ocular massage effect', followed by ultrasound pachymetry. The results from each method were compared and assessed for repeatability and between-observer reproducibility. Analysis was performed to determine the correlation between the differences in IOP measurements and corneal thicknesses. RESULTS The mean differences (±S.D.) in sessions 1 and 2 respectively between RKT-7700 and GAT (2.6 ± 2.0 and 2.7 ± 1.4 mmHg), between CT-80 and GAT (2.8 ± 2.0 and 3.2 ± 1.3 mmHg) were statistically significant (p < 0.0001). The repeatability coefficients in sessions 1 and 2 respectively were; ±1.2 and ±1.0 mmHg (GAT), ±1.3 and ±1.6 mmHg (CT-80), ±2.3 and ±1.7 mmHg (RKT-7700) and inter-observer reproducibility was; ±1.9 (RKT-7700), ±2.3 (GAT) and ±2.6 mmHg (CT-80). Between the corneal thickness and the differences in GAT-measured and NCT-measured IOPs, there was a significant negative correlation and a trend for a larger difference in thicker corneas. CONCLUSION Neither the RKT-7700 nor the CT-80 can be used interchangeably with the Goldmann tonometer, although all three tonometers give repeatable measurements of IOP, in this sub-population. IOP differences between GAT and the NCTs significantly correlated with CCT, with the possibility of even greater differences in thicker corneas.
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Affiliation(s)
- Kelechi C Ogbuehi
- Corneal Research Chair, Department of Optometry and Vision Sciences, King Saud University, Riyadh, Saudi Arabia
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Jansson U, Brautaset R, Cerviño A, Nilsson M. A comparison of the Canon TX-20P™ non-contact tonometer and pachymeter in healthy eyes. ACTA ACUST UNITED AC 2012. [DOI: 10.12968/ijop.2012.3.3.96] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Ulrika Jansson
- Unit of Optometry, Department of Clinical Neuroscience, Karolinska Institutet, Box 8056, 104 20 Stockholm, Sweden,
| | - Rune Brautaset
- Unit of Optometry, Department of Clinical Neuroscience, Karolinska Institutet, Box 8056, 104 20 Stockholm, Sweden,
| | | | - Maria Nilsson
- Unit of Optometry, Department of Clinical Neuroscience, Karolinska Institutet, Box 8056, 104 20 Stockholm, Sweden
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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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Lim TC, Chattopadhyay S, Acharya UR. A survey and comparative study on the instruments for glaucoma detection. Med Eng Phys 2011; 34:129-39. [PMID: 21862378 DOI: 10.1016/j.medengphy.2011.07.030] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2011] [Revised: 07/20/2011] [Accepted: 07/22/2011] [Indexed: 02/08/2023]
Abstract
Glaucoma is one of the leading causes of irreversible blindness worldwide. It has been proposed that the intraocular pressure is a causative factor in the development of glaucoma, which is an optic neuropathy. This paper surveys the use of tonometers, gonioscopes, optical coherence tomographs, scanning laser polarimeters, scanning laser ophthalmoscopes (also known as scanning laser tomographs) and corneal pachymeters for the diagnosis and management of glaucoma. The working mechanisms as well as the comparative advantages and disadvantages of each of these instruments are presented.
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Affiliation(s)
- Teik-Cheng Lim
- School of Science and Technology, SIM University, Singapore 599491, Singapore.
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20
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AlMubrad TM. Performance of the PT100 noncontact tonometer in healthy eyes. Clin Ophthalmol 2011; 5:661-6. [PMID: 21629572 PMCID: PMC3104795 DOI: 10.2147/opth.s19885] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2011] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The purpose of this study was to assess the repeatability and reproducibility of the PT100 noncontact tonometer and to compare its consistency with the Goldmann applanation tonometer (GAT) in measuring intraocular pressure (IOP). METHODS Triplicate IOP measurements were obtained on two separate occasions using the PT100 and GAT from randomly selected eyes in 66 healthy volunteers aged 22 ± 1 years. The repeatability and reproducibility of each techniques was assessed. Agreement between the techniques was statistically quantified using intrasession repeatability for each technique as the basis for comparison. RESULTS Both techniques returned equal IOP values in the first measurement session (15 ± 3 mmHg). The second session showed a mean difference in average IOP (1 ± 0.71). The 95% limits of agreement between the techniques were -5.2 to 5.5 mmHg and -4.0 to 4.7 mmHg (sessions 1 and 2, respectively). These mean differences were not statistically significant (P > 0.05, paired t-test), with the PT100 underestimating IOP measurement by 1.00 mmHg. The mean intrasession IOP for GAT sessions 1 and 2 was 0 ± 0.90 mmHg and 0.04 ± 1.06 mmHg, respectively, and the corresponding mean IOP measurement difference for the PT100 was -0.06 ± 0.96 and -0.39 ± 0.94 mmHg (sessions 1 and 2, respectively; P > 0.05, paired t-test). Repeatability coefficients for the GAT IOP measurements were 1.8 mmHg and 2.1 mmHg for sessions 1 and 2, while the PT100 repeatability coefficient was 1.9 mmHg and 1.8 mmHg for sessions 1 and 2, respectively. The intrasession repeatability coefficient of both techniques for test-retest differences were within ±5 mmHg. CONCLUSION The PT100 noncontact tonometer produced greater repeatability than the GAT in assessment of IOP, whereas GAT resulted in more reproducible results. Both techniques showed a close level of agreement on comparison, with the PT100 underestimating IOP measurement by 1.0 mmHg only, although this was not clinically or statistically significant. Of importance is that the IOP measurements using these techniques could be interchangeable in the IOP range studied here.
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Affiliation(s)
- Turki M AlMubrad
- Cornea Research Chair, Department of Optometry, College of Applied Medical Sciences, King Saud University, Riyadh, Kingdom of Saudi Arabia.
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Jorge J, Fernandes P, Queirós A, Ribeiro P, Ferreira A, Gonzalez-Meijome JM. Clinical evaluation of the IOPen® in a glaucomatous population. Ophthalmic Physiol Opt 2011; 30:860-4. [PMID: 21205273 DOI: 10.1111/j.1475-1313.2010.00783.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The aim of this study was to evaluate the level of agreement of measurements of intraocular pressure (IOP) taken by a rebound tonometer (IOPen®), in comparison to a reference Goldmann applanation tonometer (GAT) in a glaucomatous population. Both eyes from 60 patients were assessed with the two tonometers, the induction tonometry was performed first by an experienced optometrist, and the GAT by an ophthalmologist. In this study, statistically significant differences were found when comparing the IOPen® tonometer with the GAT tonometer (p < 0.001), mean differences were -4.81 ± 4.31 and -4.76 ± 5.76 mmHg (mean ± S.D.) for the right eye and left eye respectively These values represent an underestimation in the present population by the IOPen® when compared with the GAT. Frequency distribution of differences demonstrated that in more than 71.6% of the measurements the IOP readings differed by more than 3 mmHg between the two tonometers. These results suggest that IOPen® should be used with great caution in the determination of IOP.
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Affiliation(s)
- J Jorge
- Center of Physics, School of Science, University of Minho, Campus de Gualtar, Braga, Portugal.
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Takenaka J, Mochizuki H, Kunihara E, Tanaka J, Kiuchi Y. Evaluation of Rebound Tonometer for Measuring Intraocular Pressure at Deviated Angle and Position. Curr Eye Res 2011; 36:422-8. [DOI: 10.3109/02713683.2010.534574] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Jorge J, González-Méijome JM, Queirós A, Fernandes P, Diaz-Rey JA. A comparison of the NCT Reichert R7 with Goldmann applanation tonometry and the Reichert ocular response analyzer. Ophthalmic Physiol Opt 2011; 31:174-9. [PMID: 21309804 DOI: 10.1111/j.1475-1313.2010.00817.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Repeatability of intra-ocular pressure and central corneal thickness measurements provided by a non-contact method of tonometry and pachymetry. Graefes Arch Clin Exp Ophthalmol 2010; 249:429-34. [DOI: 10.1007/s00417-010-1550-3] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2010] [Revised: 10/05/2010] [Accepted: 10/10/2010] [Indexed: 10/18/2022] Open
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Baptista AMG, De Sousa RARC, Serra PM, Abreu CMDS, Da Silva CMLR. Evaluation of discomfort of Goldmann tonometry without anaesthetic. Ophthalmic Physiol Opt 2010; 30:854-9. [DOI: 10.1111/j.1475-1313.2010.00786.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Jorge J, Fernandes P, Queirós A, Ribeiro P, Garcês C, Gonzalez-Meijome JM. Comparison of the IOPen and iCare rebound tonometers with the Goldmann tonometer in a normal population. Ophthalmic Physiol Opt 2010; 30:108-12. [PMID: 20444114 DOI: 10.1111/j.1475-1313.2009.00697.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
This study proposes to evaluate the level of accuracy of intraocular pressure (IOP) measurements of a second generation rebound tonometer (IOPen, taking as references the Goldmann Applanation Tonometer (GAT) and the iCare rebound tonometer. The right eyes of 101 consecutive clinical patients were assessed with the three tonometers. The IOPen and iCare measurements were taken by two different optometrists and the GAT by an ophthalmologist. In this study, statistically significant differences were found when comparing the IOPen tonometer with the other two tonometers (p < 0.001). The IOPen underestimated the IOP value when compared to the GAT and the iCare (mean differences were 2.94 +/- 4.65 mmHg and 3.20 +/- 4.72 mmHg (mean +/- S.D.), respectively). The frequency distribution of differences demonstrated that in more than 55% of measurements the IOP readings differed by more than 3 mmHg between the IOPen and the GAT. Based on the present population study, these results suggest that IOPen measurements should be interpreted with caution.
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Affiliation(s)
- J Jorge
- Department of Physics (Optometry), School of Sciences, University of Minho, Campus de Gualtar, Braga.
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García-Resúa C, Giráldez Fernández MJ, Yebra-Pimentel E, García-Montero S. Clinical evaluation of the Canon TX-10 noncontact tonometer in healthy eyes. Eur J Ophthalmol 2010; 20:523-30. [PMID: 20037897 DOI: 10.1177/112067211002000326] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE To assess the accuracy and repeatability of intraocular pressure (IOP) measurements obtained with the Canon TX-10 noncontact tonometer (NCT), using the Goldmann applanation tonometer (GAT) as the gold standard. METHODS Seventy-three young healthy subjects were enrolled in the study. Central corneal thickness (CCT) was obtained with Orbscan Topography System and then repeated IOP measurements were obtained with both tonometers. Canon TX-10 NCT was performed first, followed by GAT. Another study sample of 32 young healthy subjects was used to test the repeatability with both tonometers. Two sets of data were acquired separated by 1 week. Plotting the difference between the methods against the mean was done to compare the tonometers and the intersession variability. The hypothesis of zero bias was examined by a paired t test. The 95% limits of agreement (LoA) were also calculated. RESULTS No statistically significant differences were found when comparing the Canon TX-10 NCT with GAT, displaying close level of agreement with GAT as seen by the 95% LoA (-4.78 mmHg to +4.00 mmHg). CCT ranged from 419 microm to 585 microm and no relationship was found between CCT and IOP measurements. The coefficients of repeatability were 3.70 mmHg and 3.41 mmHg for GAT and TX-10 tonometers, respectively. CONCLUSIONS There was a good agreement between Canon TX-10 and GAT in healthy subjects. From the results obtained here, CCT appears to not affect IOP measurements when CCT is thinner than 570 microm.
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Affiliation(s)
- Carlos García-Resúa
- Department of Applied Physics (Optometry Group), University of Santiago de Compostela, Escuela de Optica y Optometria, Campus Sur, Santiago de Compostela - Spain.
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Evaluation of agreement between intraocular pressure measurements using Goldmann applanation tonometry and Goldmann correlated intraocular pressure by Reichert's ocular response analyser. Eye (Lond) 2010; 24:1555-60. [PMID: 20508652 DOI: 10.1038/eye.2010.83] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
PURPOSE To compare agreement of intraocular pressure (IOP) measurements using Goldmann applanation tonometry (GAT) and Goldmann correlated intraocular pressure generated (IOPg) by the Reichert ocular response analyser (ORA). METHODS Consecutive patients presenting for glaucoma evaluation underwent ORA assessment followed by examination including GAT. For each ORA assessment, measurements were taken until a waveform score (WS) of 6.5 was obtained or until five measurements were obtained per eye. The relationship between GAT and IOPg and the influence of the WS upon this relationship was evaluated. A Bland-Altman plot and linear regression were used to determine agreement between GAT and IOPg. RESULTS A total of 518 eyes of 260 patients were included in the final analysis. Increasing WS was found to predict a smaller difference between GAT and IOPg (β=-0.2, P≤0.001). Selecting the highest WS among ORA assessments of each eye, WS continued to predict concordance between GAT and IOPg (β=-0.2, P=0.006). The mean IOP difference between methods was 0.1 mm Hg (±0.3), which was found to be statistically insignificant (P=0.391). This relationship between GAT and IOPg was successfully validated using a second distinct data set of 100 eyes. GAT and IOPg measurements varied by 2 mm Hg or less in 53.9% of eyes and 5 mm Hg or less in 92.3% of eyes. CONCLUSION In clinical practice IOPg is strongly related to GAT. Although higher WS is indicative of greater IOPg/GAT concordance, its influence is minimal. This study does not support the use of a specific WS cutoff to determine quality of an IOPg measurement.
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Salim S, Linn DJ, Echols JR, Netland PA. Comparison of intraocular pressure measurements with the portable PT100 noncontact tonometer and goldmann applanation tonometry. Clin Ophthalmol 2009; 3:341-4. [PMID: 19668588 PMCID: PMC2708988 DOI: 10.2147/opth.s5537] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Purpose: Noncontact tonometers are useful when regulations preclude use of contact tonometers by medical students and other nonophthalmologists. Our study compared the measurements by the portable, noncontact tonometer (PT100) with Goldmann applanation tonometry (GAT). Methods: This was a prospective study of 98 eyes from 98 patients. Intraocular pressure (IOP) was measured by GAT and the PT100 (Reichert, Buffalo, NY). Results: Mean IOP measurements showed no significant differences in measurements performed by the two tonometers (P = 0.64). Measurements by the two tonometers were in agreement by ≤3 mmHg in 92.8% of eyes. Linear regression analysis of PT100 vs GAT measurements revealed a slope of 0.98 with r2 = 0.58. Bland–Altman analysis showed a mean difference of measurements by GAT and PT100 of −0.3 mmHg with two standard deviation = 7.1 mmHg. Conclusion: The portable noncontact PT100 tonometer provides IOP measurements comparable to GAT within the normal range of IOP.
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Affiliation(s)
- Sarwat Salim
- Hamilton Eye Institute, University of Tennessee Health Science Center, Memphis, TN, USA
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AlMubrad TM, Ogbuehi KC. The effect of repeated applanation on subsequent IOP measurements. Clin Exp Optom 2008; 91:524-9. [PMID: 18651843 DOI: 10.1111/j.1444-0938.2008.00298.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND In studies aimed at assessing the accuracy and repeatability of non-contact tonometers, the order in which these tonometers and the Goldmann tonometer are used is usually randomised despite studies in the literature that demonstrate an ocular massage effect that occurs post-applanation but not after non-contact tonometry. The purpose of this study was to investigate the effect of repeated corneal applanation on subsequent assessments of IOP. METHODS Data were obtained from 65 left eyes of 65 young, oculovisual normals. Three sets of IOP measurements were obtained, one set with the Goldmann applanation tonometer and two with the Topcon CT80 non-contact tonometer (one set each before and after applanation with the Goldmann tonometer), in each one of two separate measurement sessions, one week apart. RESULTS The average (and SD) IOP measured with the Goldmann tonometer in the first session (14.8+/-2.9 mmHg) did not vary significantly from the IOP measured with the non-contact tonometer (pre-applanation) in both sessions or with the average Goldmann IOP in the second session. The bias (mean difference +/- SD) between methods was 0.3+/-1.4 mmHg and 0.4+/-1.4 mmHg, respectively, for the first and second sessions, with the CT80 (pre-applanation) recording the higher IOP in both sessions. The within-session repeatability coefficients were +/-2.3 mmHg, +/-2.6 mmHg, +/-2.1 mmHg and +/-2.0 mmHg for the CT80 (pre-applanation) in the first and second sessions, and the Goldmann tonometer in the first and second sessions, respectively. Test-retest repeatability coefficients were +/-2.8 mmHg and +/-2.5 mmHg for the CT80 (pre-applanation) and the Goldmann tonometer respectively. Post-applanation with the Goldmann tonometer, there was a statistically significant (p<0.05) reduction (1.5+/-1.2 mmHg in session 1) in the IOP measured with the non-contact tonometer in both sessions. CONCLUSION These results suggest that repeated corneal applanation leads to a statistically significant reduction in IOP on subsequent measurements.
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Affiliation(s)
- Turki M AlMubrad
- Department of Optometry and Vision Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Kingdom of Saudi Arabia
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Intraoffice Variability of Corneal Biomechanical Parameters and Intraocular Pressure (IOP). Optom Vis Sci 2008; 85:457-62. [PMID: 18521024 DOI: 10.1097/opx.0b013e3181783a5f] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Queirós A, González-Méijome JM, Fernandes P, Jorge J, Montés-Micó R, Almeida JB, Parafita MA. Technical note: a comparison of central and peripheral intraocular pressure using rebound tonometry. Ophthalmic Physiol Opt 2008; 27:506-11. [PMID: 17718891 DOI: 10.1111/j.1475-1313.2007.00508.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
PURPOSE To compare central and peripheral intraocular pressure (IOP) readings obtained with rebound tonometry. METHODS Intraocular pressure was measured on the right eye of 153 patients (65 males, 88 females), aged from 21 to 85 years (mean +/- S.D., 55.5 +/- 15.2 years) with the ICare rebound tonometer at centre, and 2 mm from the limbus (in the nasal and temporal regions along the 0-180 degrees corneal meridian). RESULTS Intraocular pressure values obtained with the ICare were 14.9 +/- 2.8; 14.1 +/- 2.5 and 14.5 +/- 2.7 mmHg at centre, nasal and temporal corneal locations, respectively. On average, nasal and temporal IOP readings were 0.75 and 0.37 mmHg lower than the central reading (p < 0.05 and p > 0.05, respectively). A highly significant correlation was found between central and peripheral measurements in nasal (r(2) = 0.905; p < 0.001) and temporal (r(2) = 0.879; p < 0.001) regions along the horizontal meridian. Almost 80% of patients presented nasal IOP values within +/-1 mmHg of the central value. CONCLUSIONS Intraocular pressure values measured with the ICare rebound tonometer on the nasal corneal region is slightly lower on average and highly correlated with IOP values recorded at corneal centre. Both nasal and temporal readings are in good agreement with central IOP, and could be used to obtain a reliable estimate of rebound IOP in corneas where central readings cannot be taken.
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Affiliation(s)
- A Queirós
- Department of Physics (Optometry), School of Sciences, University of Minho, Braga, Portugal
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Diaz A, Yebra-Pimentel E, Resua CG, Gilino J, Giraldez MJ. Accuracy of the ICare rebound tonometer in glaucomatous eyes with topical ocular hypotensive medication. Ophthalmic Physiol Opt 2008; 28:29-34. [DOI: 10.1111/j.1475-1313.2007.00526.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Abstract
The approach to the diagnosis and management of glaucoma has undergone considerable changes in recent years. Current concepts of glaucoma diagnosis focus on structural assessment and structure-function correlation, and relies less on the finding of visual field abnormalities. In turn, contemporary approaches to management have also changed and revolve around earlier initiation of pressure lowering medication based on pre-perimetric findings. This article presents an approach to the assessment of the patient with suspected glaucoma, highlighting those structural and ancillary diagnostic investigations that will aid in the correct diagnosis. It also discusses the differentiation of glaucoma from other, non-glaucomatous disease processes.
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Bresson-Dumont H, Lehoux A, Kponoume C, Santiago PY. La tonométrie à air est-elle encore fiable ? J Fr Ophtalmol 2007. [DOI: 10.1016/s0181-5512(07)89656-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Cervino A. Rebound tonometry: new opportunities and limitations of non-invasive determination of intraocular pressure. Br J Ophthalmol 2006; 90:1444-6. [PMID: 17114589 PMCID: PMC1857518 DOI: 10.1136/bjo.2006.102970] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Abstract
BACKGROUND The reliability of non-contact tonometers has been reported extensively in the literature. This study was designed to assess reliability of the new Topcon CT80 non-contact tonometer in normotensive subjects, using the Goldmann tonometer as the standard. METHODS The accuracy of the Topcon CT 80 non-contact tonometer was assessed by comparing its IOP assessments with those of the Goldmann applanation tonometer, on 60 right eyes of young healthy subjects with normal intraocular pressures. Each subject's intraocular pressure was assessed with each technique on two separate occasions, one week apart. The reliability of each technique was determined by the assessment of its inter-session repeatability using the Bland-Altman method. The 95 per cent limits of agreement for the two methods were also determined. RESULTS No statistically significant difference was found between the average intraocular pressures measured with the two techniques (p > 0.05). The inter-session repeatability indices for the two techniques did not differ significantly (p > 0.05). The mean difference in intraocular measurements between the two techniques was 0.2 +/- 1.5 mmHg (mean +/- SD) and the 95 per cent limits of agreement were -3.14 and +2.74 mmHg, with the non-contact tonometer returning higher readings than the Goldmann tonometer. CONCLUSION In this sample of normotensive subjects, the Topcon CT80 non-contact tonometer proved to be accurate and as reliable as the Goldmann tonometer in the assessment of intraocular pressure. Thus, it can be used as an objective clinical method for the assessment of normal intraocular pressure.
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Affiliation(s)
- Kelechi C Ogbuehi
- Department of Optometry and Vision Sciences, College of Applied Medical Sciences, Riyadh, Kingdom of Saudi Arabia.
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González-Méijome JM, Jorge J, Queirós A, Fernandes P, Montés-Micó R, Almeida JB, Parafita MA. Age differences in central and peripheral intraocular pressure using a rebound tonometer. Br J Ophthalmol 2006; 90:1495-500. [PMID: 16885185 PMCID: PMC1857520 DOI: 10.1136/bjo.2006.103044] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
AIM To evaluate the influence of age on the measurements and relationships among central and peripheral intraocular pressure (IOP) readings taken with a rebound tonometer. METHODS The IOPs were measured using the ICare rebound tonometer on the right eyes of 217 patients (88 men and 129 women) aged 18-85 years (mean 45.9 (SD 19.8) years), at the centre and at 2 mm from the nasal and temporal limbus along the horizontal meridian. Three age groups were established: young (< or =30 years old; n = 75), middle aged (31-60 years old; n = 77) and old patients (>60 years old; n = 65). RESULTS A high correlation was found between the central and peripheral IOP readings, with the central readings being higher than the peripheral ones. Higher IOP values for the central location were found in the younger patients. Older patients had significantly lower temporal IOP readings than those for the remaining two groups (p<0.001), whereas no significant differences were found among groups when IOP was measured at the central and nasal locations. A significant decrease was observed in the nasal and temporal IOP readings as the age increased (p = 0.011 and 0.006, respectively). CONCLUSION Older patients had lower IOP values than the middle-aged and younger patients in the temporal peripheral location. A negative correlation was found between age and IOP by rebound tonometry in the corneal periphery but not in its centre.
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Affiliation(s)
- J M González-Méijome
- Department of Physics (Optometry), School of Science, University of Minho, Braga, Portugal.
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Queirós A, González-Méijome JM, Fernandes P, Jorge J, Almeida JB, Parafita MA. Non-contact tonometry synchronized with cardiac rhythm and its relationship with blood pressure. Ophthalmic Physiol Opt 2006; 26:384-91. [PMID: 16792738 DOI: 10.1111/j.1475-1313.2006.00374.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
PURPOSE The main objectives of this study were to determine the differences between non-synchronized intraocular pressure (IOP_N) and intraocular pressure readings synchronized with cardiac pulse and try to determine if these parameters are related to blood pressure values. METHODS One hundred and sixty-five right eyes from 165 volunteers (107 females, 58 males) aged from 19 to 73 years (mean +/- S.D., 29.93 +/- 11.17) were examined with the Nidek NT-4000, a new non-contact tonometer that allows the measurement of IOP synchronized with the cardiac rhythm. IOP measurements in the four different modes of synchronization were taken in a randomized order. Three measures of each parameter were taken and then averaged. The blood pressure was determined three times with a portable manometer and mean values of systolic and diastolic pressure and the pulse rate were computed. Mean arterial pressure (MAP) was determined as being 1/3 of systolic plus 2/3 of diastolic blood pressure. RESULTS The mean +/- S.D. values for the standard intraocular pressure (IOP_N: 14.76 +/- 2.86), intraocular pressure in the systolic instant or peak (IOP_P: 14.99 +/- 2.85), intraocular pressure in the middle instant between heartbeats or middle (IOP_M: 14.68 +/- 2.76), and intraocular pressure in the diastolic instant or bottom (IOP_B: 13.86 +/- 2.61) were obtained. The IOP_P was higher than the remaining values. A significant difference in mean IOP existed between IOP_B and the remaining modes of measuring (p < 0.05). Differences were statistically significant for all pair comparisons involving IOP_B. Arterial blood pressure values were systolic 125.5 +/- 14.22, diastolic 77.7 +/- 8.38 and MAP 93.64 +/- 9.44 mmHg. The pulse rate was 77.3 +/- 12.6 beats per minute. Except for the MAP (p = 0.025) there was no significant correlation between different IOP values and systolic or diastolic blood pressure, or pulse rate. CONCLUSIONS NT-4000 is able to differentiate IOP values when synchronized with the cardiac rhythm and those differences are expected to be within a range of +/-2.5 to +/- 3.0 mmHg. IOP_B seems to be the parameter whose value differs from the non-synchronized and the remaining synchronized parameters in a significant way. Other than a weak association with MAP, no significant correlation between IOP and BP was found. The measurements of IOP readings for the three modes are consistent with timings during the cardiac cycle and IOP pulse cycle.
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Affiliation(s)
- A Queirós
- Department of Physics (Optometry), School of Sciences, University of Minho, Braga, Portugal.
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García-Resúa C, González-Meijome JM, Gilino J, Yebra-Pimentel E. Accuracy of the new ICare rebound tonometer vs. other portable tonometers in healthy eyes. Optom Vis Sci 2006; 83:102-7. [PMID: 16501412 DOI: 10.1097/01.opx.0000200673.96758.7b] [Citation(s) in RCA: 72] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
PURPOSE The ICare (Tiolat Oy, Helsinki, Finland) is a new portable tonometer that measures intraocular pressure (IOP) with a new rebound method, in which a very light probe is used to make momentary contact with the cornea in slow motion. The purpose of this study is to assess the accuracy of the ICare IOP measurements by comparing them against other portable tonometers: Perkins applanation tonometer and Tono-Pen XL digital tonometer (Medtronic Solan, Jacksonville, FL). METHODS Sixty-five young subjects were assessed with each of the tonometers. ICare tonometry was performed first, followed by Perkins applanation tonometry and Tono-Pen XL in a random order. Regression analysis was used to evaluate the relationship between the Perkins tonometer and the remaining tonometers used in this study. Tonometers were also compared by plotting the difference between the methods against the mean. The hypothesis of zero bias was examined by a paired t test and the 95% limits of agreement (LoA) were calculated. RESULTS ICare and Tono-Pen XL significantly overestimate IOP when compared with Perkins applanation tonometry. The mean of the difference between Perkins and ICare and Perkins and Tono-Pen XL was (mean +/- standard deviation) -3.35 +/- 2.28 mm Hg and -2.78 +/- 2.53 mm Hg, respectively. The 95% LoA between Perkins tonometry and ICare tonometry were between -7.81 and +1.12 and between Perkins tonometry and Tono-Pen XL tonometry between -7.74 and +2.18. CONCLUSIONS Compared with Perkins tonometry, the ICare tonometer allows clinicians to estimate IOP with a portable, rapid, and noninvasive method with similar reliability to that offered by Tono-Pen XL. Clinicians should be aware of the systematic overestimation of IOP with the ICare. Further research is needed to evaluate the performance of rebound tonometry in populations with higher IOP and assess the reliability of this technique in the early detection and follow up of glaucomatous patients.
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Affiliation(s)
- Carlos García-Resúa
- Department of Applied Physics (Optometry Group), University of Santiago de Compostela, Spain
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Cheng ACK, Fan D, Tang E, Lam DSC. Effect of Corneal Curvature and Corneal Thickness on the Assessment of Intraocular Pressure Using Noncontact Tonometry in Patients After Myopic LASIK Surgery. Cornea 2006; 25:26-8. [PMID: 16331036 DOI: 10.1097/01.ico.0000164833.69668.02] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To evaluate the effect of corneal curvature and corneal thickness on the assessment of intraocular pressure (IOP) using noncontact tonometry (NCT) in patients after myopic LASIK surgery. METHODS All patients who had myopic LASIK in a university-based eye clinic between February 2002 and May 2002 were retrospectively analyzed. Preoperative NCT was compared with postoperative NCT, postoperative corneal thickness, and postoperative corneal curvature. RESULTS The difference between the mean preoperative NCT (15.46 +/- 2.50 mm Hg) and postoperative NCT (6.30 +/- 1.57 mm Hg) was significant (9.16 +/- 1.96 mm Hg, P < 0.010). Preoperative NCT significantly correlated with postoperative NCT (P < 0.001), postoperative corneal thickness (P = 0.006), and postoperative anterior corneal curvature (P < 0.010). CONCLUSIONS Both corneal thickness and anterior corneal curvature affect IOP assessment in patients with myopic LASIK. Although correction formulas can be used to estimate the actual IOP, alternative methods should be investigated to assess IOP independent of corneal thickness and curvature.
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Affiliation(s)
- Arthur C K Cheng
- Department of Ophthalmology & Visual Sciences, The Chinese University of Hong Kong, University Eye Center, Hong Kong Eye Hospital, 147K Argyle Street, People's Republic of China.
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Tonnu PA, Ho T, Sharma K, White E, Bunce C, Garway-Heath D. A comparison of four methods of tonometry: method agreement and interobserver variability. Br J Ophthalmol 2005; 89:847-50. [PMID: 15965164 PMCID: PMC1772716 DOI: 10.1136/bjo.2004.056614] [Citation(s) in RCA: 155] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
AIM To compare the inter-method agreement in intraocular pressure (IOP) measurements made with four different tonometric methods. METHODS IOP was measured with the Goldmann applanation tonometer (GAT), Tono-Pen XL, ocular blood flow tonograph (OBF), and Canon TX-10 non-contact tonometer (NCT) in a randomised order in one eye of each of 105 patients with ocular hypertension or glaucoma. Three measurements were made with each method, and by each of two independent GAT observers. GAT interobserver and tonometer inter-method agreement was assessed by the Bland-Altman method. The outcome measures were 95% limits of agreement for IOP measurements between GAT observers and between tonometric methods, and 95% confidence intervals for intra-session repeated measurements. RESULTS The mean differences (bias) in IOP measurements were 0.4 mm Hg between GAT observers, and 0.6 mm Hg, 0.1 mm Hg, and 0.7 mm Hg between GAT and Tono-Pen, OBF, and NCT, respectively. The 95% limits of agreement were smallest (bias +/-2.6 mm Hg) between GAT observers, and larger for agreement between the GAT and the Tono-Pen, OBF, and NCT (bias +/-6.7, +/-5.5, and +/-4.8 mm Hg, respectively). The OBF and NCT significantly underestimated GAT measurements at lower IOP and overestimated these at higher IOP. The repeatability coefficients for intra-session repeated measurement for each method were +/-2.2 mm Hg and +/-2.5 mm Hg for the GAT, +/-4.3 mm Hg for the Tono-Pen, +/-3.7 mm Hg for the OBF, and +/-3.2 mm Hg for the NCT. CONCLUSIONS There was good interobserver agreement with the GAT and moderate agreement between the NCT and GAT. The differences between the GAT and OBF and between the GAT and Tono-Pen probably preclude the OBF and Tono-Pen from routine clinical use as objective methods to measure IOP in normal adult eyes.
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Affiliation(s)
- P-A Tonnu
- Glaucoma Research Unit, Moorfields Eye Hospital, London EC1V 2PD, UK
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Fernandes P, Díaz-Rey JA, Queirós A, Gonzalez-Meijome JM, Jorge J. Comparison of the ICareR rebound tonometer with the Goldmann tonometer in a normal population. Ophthalmic Physiol Opt 2005; 25:436-40. [PMID: 16101950 DOI: 10.1111/j.1475-1313.2005.00327.x] [Citation(s) in RCA: 117] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The aim of this study was to evaluate the accuracy of measurement of intraocular pressure (IOP) using a new induction/impact rebound tonometer (ICare) in comparison with the Goldmann applanation tonometer (AT). The left eyes of 46 university students were assessed with the two tonometers, with induction tonometry being performed first. The ICare was handled by an optometrist and the Goldmann tonometer by an ophthalmologist. In this study, statistically significant differences were found when comparing the ICare rebound tonometer with applanation tonometry (AT) (p < 0.05). The mean difference between the two tonometers was 1.34 +/- 2.03 mmHg (mean +/- S.D.) and the 95% limits of agreement were +/-3.98 mmHg. A frequency distribution of the differences demonstrated that in more than 80% of cases the IOP readings differed by <3 mmHg between the ICare and the AT. In the present population the ICare overestimates the IOP value by 1.34 mmHg on average when compared with Goldmann tonometer. Nevertheless, the ICare tonometer may be helpful as a screening tool when Goldmann applanation tonometry is not applicable or not recommended, as it is able to estimate IOP within a range of +/-3.00 mmHg in more than 80% of the population.
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Affiliation(s)
- P Fernandes
- Department of Physics (Optometry), School of Sciences, University of Minho, Braga, Portugal.
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García Resúa C, Giráldez Fernández MJ, Cerviño Expósito A, González Pérez J, Yebra-Pimentel E. Clinical evaluation of the new TGDc-01 "PRA" palpebral tonometer: comparison with contact and non-contact tonometry. Optom Vis Sci 2005; 82:143-50. [PMID: 15711462 DOI: 10.1097/01.opx.0000153164.51951.58] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
PURPOSE The TGDc-01 "PRA" (Ryazan State Instrument, Ryazan, Russia) tonometer is a new portable small-sized tonometer that measures intraocular pressure (IOP) through the eyelid. The purpose of this study is to assess the repeatability of the TGDc-01 IOP measurements by comparing them against those obtained with Goldmann tonometer and with those from Perkins applanation tonometer, Xpert (Reichert, Depew, NY) noncontact tonometer, and Tono-Pen XL (Medtronic Solan, Jacksonville, FL) digital tonometer. METHODS Fifty-eight right eyes of 58 young subjects were measured with each of the tonometers. Noncontact tonometry was performed first, followed by Goldmann and Perkins applanation tonometer (in random order), digital Tono-Pen XL, and finally TGDc-01 tonometer (sitting and supine position). Correlation analysis was used to evaluate the relationship between the Goldmann tonometer and the remaining tonometers used in this study. Plotting the difference between the methods against mean was also done to compare the tonometers. The hypothesis of zero bias was examined by a paired t-test. The 95% limits of agreement (LoA) were also calculated. RESULTS TGDc-01 showed no statistical difference between the IOP measurements obtained in sitting and supine positions. A poor relationship between the TGDc-01 and Goldmann tonometer was found (r = 0.173; p = 0.001). Although the mean differences between Goldmann and Tonopen XL, Xpert, and TGDc-01 IOP measurements were statistically significant, the wider 95% LoA was observed when comparing the Goldmann and TGDc-01 tonometers. Computation of the 95% LoA resulted in a wide bias range when comparing the TGDc-01 with all the tonometers used in this study. CONCLUSIONS The TGDc-01 "PRA" tonometer was not comparable with the other techniques used in the study. The wide dispersion range of the values obtained shows low repeatability of the TGDc-01 for screening purposes. These results could be because of the technique of measurement and/or interindividual variables.
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Affiliation(s)
- Carlos García Resúa
- Department of Applied Physics (Optometry Group), University of Santiago de Compostela, 15706 Santiago de Compostela, Galicia, Spain
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Jorge J, González-Méijome JM, Díaz-Rey JA, Almeida JB, Ribeiro P, Parafita MA. Clinical performance of non-contact tonometry by Reichert AT550 in glaucomatous patients. Ophthalmic Physiol Opt 2004; 23:503-6. [PMID: 14622352 DOI: 10.1046/j.1475-1313.2003.00139.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Measuring intraocular pressure (IOP) by non-contact tonometry (NCT) has been demonstrated to be a valid and reliable technique to be used in primary eye care; it is easier to use, it does not transmit infectious diseases, and it is not necessary to use anaesthetic or staining eye drops. Recently, a new NCT device has showed an excellent level of agreement with Goldmann tonometry, but there are no records of its performance in glaucomatous eyes. To rectify this, IOP was measured in twenty-two patients (44 eyes) receiving medical treatment to control elevated IOP, with AT550 and Goldmann tonometry. Mean values of IOP were 18.98 +/- 2.77 and 19.08 +/- 3.02 mmHg using Goldmann and AT550, respectively. Plots of differences against means displayed good agreement (mean difference +/- limits of agreement, -0.09 +/- 3.30); this value was not significantly different from zero (t-test for dependent samples, p = 0.709). In conclusion, IOP values as measured with the AT550 NCT are clinically comparable with those obtained with Goldmann tonometry in glaucomatous patients. This validates this NCT not only for screening of IOP but to follow-up glaucomatous patients with a rapid, non-invasive method.
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Affiliation(s)
- J Jorge
- Department of Physics (Optometry), School of Sciences, University of Minho, Braga, Portugal.
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Davies LN, Bartlett HE, Dunne MCM. Cling film as a barrier against CJD in Goldmann-type applanation tonometry. Ophthalmic Physiol Opt 2004; 24:27-34. [PMID: 14687198 DOI: 10.1046/j.1475-1313.2003.00161.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE To determine the feasibility of taking intra-ocular pressure (IOP) readings with Goldmann-type applanation tonometer probe covered with cling film to avoid transmission of Creutzfeldt-Jakob disease (CJD). METHODS Data were collected on two occasions from the right eyes of 30 healthy subjects using a Perkins applanation tonometer. On each occasion, a single tonometry measurement was made with and without cling film covering. RESULTS Cling film covering brought about a statistically significant IOP bias (-0.8 mmHg on first occasion and -1.17 mmHg on second occasion). The 95% limits of agreement, between readings made with and without cling film covering, were +/-3.4 mmHg on first occasion; +/-2.5 mmHg on second occasion. A statistically significant reduction of inter-sessional repeatability was observed for readings taken with cling film (+/-5.2 mmHg) compared to those made without (+/-3.9 mmHg). CONCLUSIONS Even if the above findings are found to be acceptable, given the known intra-subject variations of this type of tonometry (+/-4 mmHg), ethical and legal considerations relating to the barrier properties of cling film are likely to prevent its routine use by optometrists.
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Affiliation(s)
- Leon N Davies
- Neurosciences Research Institute, Aston University, Aston Triangle, Birmingham B4 7ET, UK
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