1
|
Stodtmeister R, Menzel A, Klimova A, Herber R, Pillunat KR, Pillunat LE. Measurement of the retinal venous pressure with a new instrument in patients with primary open angle glaucoma. Graefes Arch Clin Exp Ophthalmol 2024; 262:1633-1639. [PMID: 38214734 PMCID: PMC11031493 DOI: 10.1007/s00417-023-06326-4] [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: 02/04/2022] [Revised: 08/28/2023] [Accepted: 11/20/2023] [Indexed: 01/13/2024] Open
Abstract
PURPOSE To compare the results of retinal venous pressure (RVP) measurement performed with contact lens dynamometry (CLD) and with the new IOPstim. METHODS In this cross-sectional study, we included 36 patients with primary open angle glaucoma with a median age (Q25; Q75) of 74 (64; 77) years (m/f = 18/18), baseline intraocular pressure (IOP): 13.9 (12.2; 15.1) mmHg. Median mean defect: - 5.8 (- 11.9; - 2.6) db. Principle of the IOPstim: an empty balloon with a diameter of 8 mm is positioned on the eye, laterally of the limbus. Under observation of the central retinal vein (CRV), the examiner inflates the balloon. As soon as the CRV starts pulsation, the inflation is stopped and the IOP is measured, equaling the RVP at this moment. In the CLD, the pulsation of the CRV is observed with a contact lens. The RVP is calculated from the attachment force applied when pulsation appears. COURSE OF EXAMINATIONS Three single measurements of RVP in quick succession with both methods. The sequence of the two methods was randomized. The means of the three RVP measurements were compared. RESULTS Pressures in mmHg. RVP: IOPstim: 19.4 ± 5.4 (mean ± SD), CLD: 20.3 ± 5.9. Range of three single measurements: IOPstim: 2.9 ± 1.5, CLD: 2.2 ± 1.1. The differences were RVPIOPstim - RVPCLD = - 0.94 ± 1.15, and approximately normally distributed. Bland-Altman analysis: only one data point was 0.5 mmHg higher than the upper line of agreement. The confidence interval of this line was 0.65 mmHg. Concordance correlation coefficient according to Lin (CCC): 0.96. Intraclass correlation coefficient: both methods, 0.94. CONCLUSION In both methods, the range of the single measurements may be taken as a sign of good reliability, the CCC of 0.96 as a sign of a very good agreement. At the mean, the IOPstim RVP values were 1 mmHg lower than those obtained with the CLD. This difference may be due to the different directions of the prevailing force vectors induced by the instruments. The IOPstim seems applicable in glaucoma diagnostics.
Collapse
Affiliation(s)
- Richard Stodtmeister
- Department of Ophthalmology, Univ. Hospital Carl Gustav Carus, TU Dresden, Fetscherstrasse 74, 01307, Dresden, Germany
| | - Aline Menzel
- Department of Ophthalmology, Univ. Hospital Carl Gustav Carus, TU Dresden, Fetscherstrasse 74, 01307, Dresden, Germany
| | - Anna Klimova
- National Center for Tumor Diseases (NCT/UCC), German Cancer Research Center (DKFZ), Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Helmholtz-Zentrum Dresden-Rossendorf (HZDR), 01307, Dresden, Germany
| | - Robert Herber
- Department of Ophthalmology, Univ. Hospital Carl Gustav Carus, TU Dresden, Fetscherstrasse 74, 01307, Dresden, Germany
| | - Karin R Pillunat
- Department of Ophthalmology, Univ. Hospital Carl Gustav Carus, TU Dresden, Fetscherstrasse 74, 01307, Dresden, Germany.
| | - Lutz E Pillunat
- Department of Ophthalmology, Univ. Hospital Carl Gustav Carus, TU Dresden, Fetscherstrasse 74, 01307, Dresden, Germany
| |
Collapse
|
2
|
Duran M. Comparison of intraocular pressure measurements obtained by icare pro tonometer, non-contact tonometer and Goldmann applanation tonometer in healthy individuals. J Fr Ophtalmol 2023; 46:1195-1203. [PMID: 37666735 DOI: 10.1016/j.jfo.2023.01.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 01/16/2023] [Accepted: 01/19/2023] [Indexed: 09/06/2023]
Abstract
PURPOSE The goal of this paper was to compare the intraocular pressure (IOP) measurements obtained via iCare Pro rebound (IRT), non-contact tonometry (NCT), and Goldmann applanation (GAT) tonometry in healthy subjects. MATERIALS AND METHODS One hundred and twenty-five healthy individuals were included in this study. The participants' IOP measurements were obtained via non-contact tonometry. After routine ophthalmic examination, central corneal thickness (CCT) was measured with a topography device. Intraocular pressure was measured via iCare Pro rebound tonometry. After waiting for 5minutes, three measurements were taken with GAT under topical anaesthesia, and their means were recorded. Interdevice agreement was evaluated with the intraclass correlation coefficient (ICC) and Bland-Altman analysis. RESULTS The mean IOP measurements for NCT, IRT, and GAT were 15.97±2.99, 17.47±2.86, and 16.46±2.68mmHg, respectively. The mean difference between NCT and GAT was -0.49± 1.89mmHg, the mean difference between IRT and GAT was 1.01±1.90mmHg, and the mean difference between NCT and IRT was -1.50±2.02mmHg. Agreement between devices was found to be >0.8 for each tonometry ICC. There were significant positive correlations between the measurements obtained via these three instruments and CCT. CONCLUSION In this study, IOP was measured slightly lower with NCT than GAT, but it was about 1mmHg higher with IRT than GAT on average. All three devices appeared to be affected by CCT, with NCT being the most affected in this regard. The three instruments can be used for routine inspection and screening. However, considering the differences in the measurements obtained by using them, it is clear that following up IOP measurements with GAT measurements is beneficial in advanced glaucoma patients.
Collapse
Affiliation(s)
- M Duran
- Department of Ophthalmology, Erol Olcok Training and Research Hospital, Hitit University, Inönü avenue, N(o) 176, 19040, Çorum, Turkey.
| |
Collapse
|
3
|
Lin CW, Wang JJ, Lai CH, Chen CY, Lai IC. Assessing Agreement and Variability Among Alternative Devices for Intraocular Pressure Measurement: A Comparative Study. Clin Ophthalmol 2023; 17:3453-3461. [PMID: 38026610 PMCID: PMC10657745 DOI: 10.2147/opth.s438358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Accepted: 11/01/2023] [Indexed: 12/01/2023] Open
Abstract
Purpose Intraocular pressure (IOP) measurement is critical in diagnosing and managing eye conditions. This study aims to assess the comparability of three alternative devices for measuring IOP: Noncontact tonometer, Icare rebound tonometer, and Tono-Pen. Patients and Methods A cross-sectional study included 172 adult participants (87 males and 85 females) who underwent IOP and central corneal thickness (CCT) assessments. IOP was measured using Noncontact (Canon TX-20), Icare (Icare TA01i), and Tono-Pen (Tonopen XL). CCT was measured with the built-in pachymetry of the Noncontact tonometer. Correlation coefficients and Bland-Altman analyses were conducted to assess the relationships and agreements between these tonometers. Participants were grouped based on IOP and CCT levels. The mean of the standard deviation of the three tonometer results was calculated to evaluate measurement result variability. One-way analysis of variance was conducted for comparing between the groups. Results IOP measurements among the three devices were not significantly different, indicating their comparability. Correlation analysis revealed strong correlations between the tonometers. Bland-Altman analysis showed good agreement, with the Icare rebound tonometer and Tono-Pen exhibiting narrower limits of agreement. Furthermore, IOP levels influenced measurement result variability, with higher IOP levels associated with greater variance. Conclusion This study demonstrates that the alternative devices examined can provide reliable IOP measurements. It highlights the potential of these alternative devices for IOP measurement. These findings have implications for clinical practice, offering practitioners additional tools for accurate IOP assessment.
Collapse
Affiliation(s)
- Chen-Wei Lin
- Department of Medical Education, Chang Gung Memorial Hospital, Chiayi, 61363, Taiwan
- Department of Ophthalmology, Chang Gung Memorial Hospital, Chiayi, 61363, Taiwan
| | - Jin-Jhe Wang
- Department of Ophthalmology, Chang Gung Memorial Hospital, Chiayi, 61363, Taiwan
| | - Chien-Hsiung Lai
- Department of Ophthalmology, Chang Gung Memorial Hospital, Chiayi, 61363, Taiwan
- Department of Medicine, Chang Gung University, Taoyuan, 33302, Taiwan
- Department of Nursing, Chang Gung University of Science and Technology, Chiayi, 61363, Taiwan
- School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan, 33302, Taiwan
| | - Chau-Yin Chen
- Department of Ophthalmology, Chang Gung Memorial Hospital, Chiayi, 61363, Taiwan
- Department of Medicine, Chang Gung University, Taoyuan, 33302, Taiwan
| | - Ing-Chou Lai
- Department of Ophthalmology, Chang Gung Memorial Hospital, Chiayi, 61363, Taiwan
- Department of Medicine, Chang Gung University, Taoyuan, 33302, Taiwan
- Department of Ophthalmology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, 83301, Taiwan
| |
Collapse
|
4
|
Powell S, Doolan E, Curtin K, Doyle A, O'Brien C. Audit of outcomes following attendance at the City West drive-through IOP glaucoma clinic during the COVID-19 pandemic. Ir J Med Sci 2022; 191:2813-2822. [PMID: 35034276 PMCID: PMC8761105 DOI: 10.1007/s11845-021-02893-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 12/07/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Glaucoma is the leading cause of irreversible blindness globally. During the COVID-19 pandemic, an enforced reduction in capacity resulted in the deferral of routine outpatient appointments for glaucoma patients. AIM This study analyses patient outcomes following the establishment of a drive-through intra-ocular pressure (IOP) clinic during the COVID-19 pandemic to alleviate increased pressure on the tertiary glaucoma services at Royal Victoria Eye and Ear Hospital (RVEEH) and Mater Misericordiae University Hospital (MMUH) between August 2020 and June 2021. METHODS A 1-lane driveway system was established in a marquee on the grounds of City West hotel. IOPs were measured in patients' cars using a hand held iCare100 tonometer. Results were reviewed by a consultant ophthalmologist. At hospital follow-up clinic visits, IOP was measured using the Goldmann applanation tonometer (GAT). RESULTS Three hundred one patients of a total of 672 who attended the drive-through clinic have subsequently attended a designated hospital follow-up appointment. In this cohort, the mean drive-through iCare IOP of 19.4 mmHg ± 6.0 was significantly higher (< 0.005) than the mean GAT IOP at the pre-drive through clinic visit (16.3 mmHg ± 3.7) and the post drive-through hospital follow-up visit (17.2 mmHg ± 4.1). Two hundred twenty-six (75%) patients did not need any treatment change, 53 (18%) required eye drop medication changes, 10 (3%) underwent a laser procedure, 4(1%) required surgical intervention, and 8 (3%) were discharged. When patient outcomes were analysed according to IOP grade assigned at the drive-through clinic, those with an iCare IOP < 21 were significantly less likely to require a treatment change. The cohort with iCare IOP ≥ 30 were significantly more likely to have a laser or surgical intervention. CONCLUSION The implementation of a drive-through IOP clinic was a safe and effective way to monitor glaucoma patients during COVID-19, and identify those at high risk of poor IOP control or requiring a change in treatment.
Collapse
Affiliation(s)
- Sarah Powell
- Department of Ophthalmology, Mater Misericordiae University Hospital, Dublin, Ireland
| | - Emer Doolan
- Department of Ophthalmology, Royal Victoria Eye and Ear Hospital, Dublin, Ireland
| | - Karen Curtin
- Department of Ophthalmology, Royal Victoria Eye and Ear Hospital, Dublin, Ireland
| | - Aoife Doyle
- Department of Ophthalmology, Royal Victoria Eye and Ear Hospital, Dublin, Ireland
| | - Colm O'Brien
- Department of Ophthalmology, Mater Misericordiae University Hospital, Dublin, Ireland.
| |
Collapse
|
5
|
Badakere SV, Chary R, Choudhari NS, Rao HL, Garudadri C, Senthil S. Agreement of Intraocular Pressure Measurement of Icare ic200 with Goldmann Applanation Tonometer in Adult Eyes with Normal Cornea. Ophthalmol Glaucoma 2021; 4:238-243. [PMID: 34030826 DOI: 10.1016/j.ogla.2021.04.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Revised: 08/04/2020] [Accepted: 08/06/2020] [Indexed: 10/21/2022]
Abstract
PURPOSE To study the agreement between the Icare ic200 (ICare Finland Oy, Helsinki, Finland) and the Goldmann Applanation Tonometer (GAT) in the measurement of intraocular pressure (IOP) in adult eyes. DESIGN Noninterventional, cross-sectional study. PARTICIPANTS A total of 156 eyes of 156 adult participants with clear corneas were included. METHODS The IOP measurements were obtained with the Icare ic200 by 1 observer followed by GAT readings by a second masked observer. The central corneal thickness (CCT) and biometry of all subjects were recorded. MAIN OUTCOME MEASURES The agreement between Icare ic200 and GAT was measured using the Bland-Altman plot. RESULTS The mean age ± standard deviation of subjects was 55.3 ± 13.7 years. The GAT IOP ranged from 6 to 50 mmHg with a mean IOP of 19.5 ± 8.8 mmHg. The Icare ic200 IOP ranged from 7.4 to 50 mmHg with a mean IOP of 20.8 ± 9.3 mmHg. The mean difference between the IOP measurement of GAT and Icare ic200 was -1.27 mmHg with the 95% limits of agreement (LoA) ranging from -3.4 to 0.9 mmHg for all ranges of IOP. The mean difference (95% LoA) between the IOP measurement of GAT and Icare ic200 was -1 mmHg (-3 to 1 mmHg) and -1.8 mmHg (-4 to 0.2 mmHg) for a GAT IOP ≤21 mmHg and >21 mmHg, respectively. The CCT, axial length, age, and gender did not significantly affect the difference in measurement of IOP between the 2 tonometers. However, for every 1-mmHg increase in GAT IOP, the difference between the 2 tonometers increased by 0.04 mmHg (P < 0.001). CONCLUSIONS In our study, the Icare ic200 overestimated the IOP. The overestimation increased as the baseline IOP increased. The agreement between the IOP measurement by GAT and Icare ic200 was <2 mmHg at all ranges of IOP. The narrow LoA between the tonometers for an IOP <21 mmHg makes it a useful alternative to GAT in this pressure range.
Collapse
Affiliation(s)
| | - Raghava Chary
- VST center for Glaucoma, L V Prasad Eye Institute, Hyderabad, India
| | | | - Harsha L Rao
- Narayana Nethralaya, Bannerghatta Road, Bangalore, India
| | | | - Sirisha Senthil
- VST center for Glaucoma, L V Prasad Eye Institute, Hyderabad, India.
| |
Collapse
|
6
|
Olyntho Junior MADC, Augusto LB, Gracitelli CPB, Tatham AJ. The Effect of Corneal Thickness, Densitometry and Curvature on Intraocular Pressure Measurements Obtained by Applanation, Rebound and Dynamic Contour Tonometry. Vision (Basel) 2020; 4:vision4040045. [PMID: 33096873 PMCID: PMC7711663 DOI: 10.3390/vision4040045] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 10/10/2020] [Accepted: 10/19/2020] [Indexed: 02/01/2023] Open
Abstract
Evaluate the effect of corneal thickness, densitometry and curvature on intraocular pressure (IOP) measurements obtained by Goldmann applanation tonometry (GAT), non-contact tonometry (NCT), rebound tonometry (RT), and dynamic contour tonometry (DCT). A cross-sectional prospective study involving 40 participants was performed. Corneal measurements were obtained using Pentacam (Oculus GMbH, Wetzlar, Germany), densitometry was measured at annuli of 0–2, 2–6, 6–10 and 10–12 mm. The relationship between corneal thickness (central, 4 and 6 mm), corneal astigmatism and corneal densitometry and IOP was examined. There was a significant relationship between corneal thickness (central, 4 and 6 mm) and GAT180, GAT90, RT, and NCT (P < 0.001 for all comparisons) but not for DCT. Higher corneal densitometry (6–10 mm and 10–12 mm zones) was associated with higher IOP from GAT180 and GAT90, and higher densitometry in the 6–10 mm zone correlated with higher IOP from NCT, however corneal densitometry increased with age. Accounting for age, the relationship between corneal densitometry and IOP measurements was not significant. In eyes with greater corneal astigmatism there was a greater difference between GAT90 and GAT180 measurements. IOP measurements may be affected by corneal thickness, densitometry and curvature. DCT was less affected by properties of the cornea compared to other devices.
Collapse
Affiliation(s)
| | | | - Carolina P B Gracitelli
- Department of Ophthalmology and Visual Sciences, Federal University of São Paulo, 13565-905 São Paulo, Brazil
- Centro de Estudos Alcides Hirai, Ver Mais Oftalmologia, 07750-000 Vinhedo, São Paulo, Brazil
| | | |
Collapse
|
7
|
Agreement of Intraocular Pressure Measurement of Icare ic200 with Goldmann Applanation Tonometer in Adult Eyes with Normal Cornea. Ophthalmol Glaucoma 2020; 4:89-94. [PMID: 32801019 DOI: 10.1016/j.ogla.2020.08.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Revised: 08/04/2020] [Accepted: 08/06/2020] [Indexed: 11/23/2022]
Abstract
PURPOSE To study the agreement between the Icare ic200 (ICare Finland Oy, Helsinki, Finland) and the Goldmann Applanation Tonometer (GAT) in the measurement of intraocular pressure (IOP) in adult eyes. DESIGN Noninterventional, cross-sectional study. PARTICIPANTS A total of 156 eyes of 156 adult participants with clear corneas were included. METHODS The IOP measurements were obtained with the Icare ic200 by 1 observer followed by GAT readings by a second masked observer. The central corneal thickness (CCT) and biometry of all subjects were recorded. MAIN OUTCOME MEASURES The agreement between Icare ic200 and GAT was measured using the Bland-Altman plot. RESULTS The mean age ± standard deviation of subjects was 55.3 ± 13.7 years. The GAT IOP ranged from 6 to 50 mmHg with a mean IOP of 19.5 ± 8.8 mmHg. The Icare ic200 IOP ranged from 7.4 to 50 mmHg with a mean IOP of 20.8 ± 9.3 mmHg. The mean difference between the IOP measurement of GAT and Icare ic200 was -1.27 mmHg with the 95% limits of agreement (LoA) ranging from -3.4 to 0.9 mmHg for all ranges of IOP. The mean difference (95% LoA) between the IOP measurement of GAT and Icare ic200 was -1 mmHg (-3 to 1 mmHg) and -1.8 mmHg (-4 to 0.2 mmHg) for a GAT IOP ≤21 mmHg and >21 mmHg, respectively. The CCT, axial length, age, and gender did not significantly affect the difference in measurement of IOP between the 2 tonometers. However, for every 1-mmHg increase in GAT IOP, the difference between the 2 tonometers increased by 0.04 mmHg (P < 0.001). CONCLUSIONS In our study, the Icare ic200 overestimated the IOP. The overestimation increased as the baseline IOP increased. The agreement between the IOP measurement by GAT and Icare ic200 was <2 mmHg at all ranges of IOP. The narrow LoA between the tonometers for an IOP <21 mmHg makes it a useful alternative to GAT in this pressure range.
Collapse
|
8
|
Perez-Garcia P, Morales-Fernandez L, Saenz-Frances F, Mendez-Hernandez CD, Garcia-Feijoo J, Santos-Bueso E, Martinez-de-la-Casa JM. Comparision of intraocular pressure measured using the new icare 200™ rebound tonometer and the Perkins™ applanation tonometer in healthy subjects and in patients with primary congenital glaucoma. ACTA ACUST UNITED AC 2020; 96:175-180. [PMID: 32690372 DOI: 10.1016/j.oftal.2020.06.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 05/27/2020] [Accepted: 06/05/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To compare intraocular pressure (IOP) measurements obtained using the Icare 200™ (IC200) rebound tonometer and the hand-held version of the Goldmann Applanation Tonometer (Perkins™ tonometer, GAT) in patients with primary congenital glaucoma (PCG) and in healthy subjects. MATERIAL AND METHODS A total of 42 eyes of healthy subjects (G1) and 40 patients with PCG (G2) were analysed. The following clinical data were collected: gender, age, Cup/Disc ratio, central corneal thickness (CCT). IOP was determined in the examination room using the IC200 and GAT tonometers, in the same order. Agreement between both tonometers was determined using the intraclass correlation coefficient (ICC) and Bland-Altman plot. A linear regression analysis was used to establish the IOP was affected by the studied variables. RESULTS Mean IOP between both tonometers (IC200 minus GAT) was: G1=15.91 (2.57) mmHg vs. 15.06 (2.12) mmHg (mean difference, MD=0.84 (0.50) mmHg; P<.101) and G2=20.10 (6.37) vs.19.12 (5.62) (MD=0.98 (1.36); P=.474). Excellent agreement was found between IC200 and GAT in both groups (ICC=G1: 0.875 (95% CI; 0.768-0.933; P<.001); G2: 0.924 (95% CI; 0.852-0.961; P<.001), and there was a statistically significant correlation between the IOP difference measured with IC200 and GAT and CCT in G1 (B=0.021; 95% CI; 0.005-0.037; P=.008), but was not statistically significant in G2. CONCLUSION There was excellent agreement between the IC200 and GAT tonometers, both in healthy subjects and PCG, with a trend to overestimate IOP when measured with IC200. There was no influence by CCT on IOP measurements in patients with PGC.
Collapse
|
9
|
McGarva E, Farr J, Dabasia P, Lawrenson JG, Murdoch IE. Initial experience in self-monitoring of intraocular pressure. Eur J Ophthalmol 2020; 31:1326-1332. [PMID: 32340488 PMCID: PMC8358569 DOI: 10.1177/1120672120920217] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background/aims Diurnal variation in intraocular pressure (IOP) is a routine assessment in glaucoma management. Providing patients the opportunity to perform self-tonometry might empower them and free hospital resource. We previously demonstrated that 74% of patients can use the Icare® HOME tonometer. This study further explores Icare® HOME patient self-monitoring. Methods Patients were trained by standard protocol to use the Icare® HOME rebound tonometer. Patient self-tonometry was compared to Goldmann applanation tonometry (GAT) over one clinical day. Following this, each patient was instructed to undertake further data collection that evening and over the subsequent two days. Results Eighteen patients (35 eyes) participated. Good agreement was demonstrated between GAT and Icare® HOME for IOPs up to 15 mm Hg. Above this IOP the Icare® tended to over-read, largely explained by 2 patients with corneal thickness >600 um. The mean peak IOP during ‘clinic hours’ phasing was 16.7 mm Hg and 18.5 mm Hg (p = 0.24) over three days. An average range of 5.0, 7.0 and 9.8 mm Hg was shown during single day clinic, single day home and three day home phasing respectively (p =<0.001). The range of IOP was lower in eyes with prior trabeculectomy (6.1 mm Hg vs 12.2 mm Hg). All patients undertook one reading in the early morning at home with an average of 4.8 readings during, and 3.1 readings after office hours. Conclusions This small study shows that self-tonometry is feasible. The findings from home phasing demonstrated higher peak and trough IOPs, providing additional clinical information. Home phasing is a viable alternative. The cost-effectiveness of this approach has yet to be addressed.
Collapse
Affiliation(s)
- Emily McGarva
- Moorfields Eye Hospital NHS Foundation Trust, London, UK
| | - Jane Farr
- Moorfields Eye Hospital NHS Foundation Trust, London, UK
| | - Priya Dabasia
- Division of Optometry and Visual Sciences, City, University of London, London, UK
| | - John G Lawrenson
- Division of Optometry and Visual Sciences, City, University of London, London, UK.,UCL Institute of Ophthalmology, London, UK
| | - Ian E Murdoch
- Moorfields Eye Hospital NHS Foundation Trust, London, UK.,UCL Institute of Ophthalmology, London, UK
| |
Collapse
|
10
|
Uzlu D, Akyol N, Türk A, Oruç Y. A comparison of three different tonometric methods in the measurement of intraocular pressure in the pediatric age group. Int Ophthalmol 2020; 40:1999-2005. [DOI: 10.1007/s10792-020-01375-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Accepted: 04/10/2020] [Indexed: 10/24/2022]
|
11
|
Abstract
SIGNIFICANCE Precise measurement of intraocular pressure (IOP) is essential when diagnosing and managing glaucoma. We compared the IOP readings of three different tonometers and analyzed agreement among tonometers in eyes with high IOPs. PURPOSE The purpose of this study was to compare the IOP readings obtained using a Goldmann applanation tonometer (GAT), a rebound tonometer (RT), and a Tono-Pen (TP) in angle-closure eyes with elevated IOP before and after medical IOP-lowering therapy. METHODS Twenty-five eyes of 25 patients with angle closure and IOPs of greater than 30 mmHg were enrolled. Intraocular pressure was measured using RT (iCare Pro), TP (Tono-Pen XL), and GAT before and after medical treatment. The mean IOP readings of the tonometers were compared before and after treatment. The agreement among the tonometers was assessed via Bland-Altman analysis. RESULTS The measurements from 22 eyes of 22 patients were suitable for statistical analyses. Before medical treatment, the mean TP-IOP was significantly lower than the mean GAT-IOP (44.0 ± 10.3 vs. 50.4 ± 8.9 mmHg, respectively; P < .001), but no significant difference was evident between the RT-IOP and the GAT-IOP (50.8 ± 10.9 vs. 50.4 ± 8.9 mmHg, respectively; P = .79). After IOP-lowering treatment, the mean GAT-IOP (14.9 ± 4.7 mmHg) did not differ from either the mean RT-IOP (15.6 ± 4.4 mmHg) or the mean TP-IOP (15.4 ± 5.0 mmHg; P = .05 and P = .18, respectively). The random measurement error among tonometers was greater for high IOP readings. CONCLUSIONS Compared with RT or GAT, TP underestimated IOP in angle-closure eyes with a GAT-IOP of greater than 30 mmHg. Intraocular pressure reading agreement among the three tonometers was lower in eyes with high IOP.
Collapse
|
12
|
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.
Collapse
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.
| |
Collapse
|
13
|
Intraocular pressure measurement after corneal transplantation. Surv Ophthalmol 2019; 64:639-646. [DOI: 10.1016/j.survophthal.2019.02.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 02/20/2019] [Accepted: 02/25/2019] [Indexed: 11/20/2022]
|
14
|
Rödter TH, Knippschild S, Baulig C, Krummenauer F. Meta-analysis of the concordance of Icare® PRO–based rebound and Goldmann applanation tonometry in glaucoma patients. Eur J Ophthalmol 2019; 30:245-252. [DOI: 10.1177/1120672119866067] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Background: The Icare® PRO rebound tonometer is being promoted as a patient-friendly device for glaucoma detection and monitoring, allowing rapid and accurate intraocular pressure measurement avoiding anaesthesia. The aim of this systematic review was to examine the concordance of Icare® PRO and Goldmann applanation tonometry in glaucoma patients. Methods: The German and English literature research was carried out using PubMed and Cochrane Library between January 2010 and March 2018. Method comparison trials in a paired sample study design were identified. Search criteria were ‘Icare PRO’, ‘Rebound’, ‘Goldmann’ and ‘Applanation’. Adult patients with glaucoma of any aetiology were included. The intraindividual intraocular pressure deviation between Icare® PRO and Goldmann applanation tonometry (mm Hg) served as primary endpoint, parameterized by the reported mean differences. For each study, an asymptotic 95% confidence interval was derived. The overall intraocular pressure meta-difference (Icare® PRO-Goldmann applanation tonometry) and 95% confidence interval were estimated using the random effect model. Result: Of 147 publications, 6 studies (672 eyes) were included after reviewing. Four studies showed an intraocular pressure underestimation by the Icare® PRO, two an overestimation. The meta-difference (Icare® PRO-Goldmann applanation tonometry = −0.14 mm Hg; 95% confidence interval: (−0.43 mm Hg; 0.15 mm Hg)) indicated a non-significant, clinically irrelevant mean deviation (p = 0.335). The devices showed good agreement, but there was a strong heterogeneity between the studies (I² = 77%): two studies presented a significant difference (Icare® PRO-Goldmann applanation tonometry), however, with deviations in opposite directions. Conclusion: Although the manufacturer advertises the Icare® PRO as a ‘tonometer with superior accuracy’, the present review could neither confirm nor deny considerable agreement between Goldmann applanation tonometry and Icare® PRO in glaucomatous patients.
Collapse
Affiliation(s)
- Tara Helena Rödter
- Institute for Medical Biometry and Epidemiology, Faculty of Health, Witten/Herdecke University, Witten, Germany
| | - Stephanie Knippschild
- Institute for Medical Biometry and Epidemiology, Faculty of Health, Witten/Herdecke University, Witten, Germany
| | - Christine Baulig
- Institute for Medical Biometry and Epidemiology, Faculty of Health, Witten/Herdecke University, Witten, Germany
| | - Frank Krummenauer
- Institute for Medical Biometry and Epidemiology, Faculty of Health, Witten/Herdecke University, Witten, Germany
| |
Collapse
|
15
|
Demirci G, Erdur SK, Tanriverdi C, Gulkilik G, Ozsutçu M. Comparison of rebound tonometry and non-contact airpuff tonometry to Goldmann applanation tonometry. Ther Adv Ophthalmol 2019; 11:2515841419835731. [PMID: 30899901 PMCID: PMC6419246 DOI: 10.1177/2515841419835731] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Accepted: 02/08/2019] [Indexed: 11/22/2022] Open
Abstract
Purpose: The aim of this study was to compare the intraocular pressure measurements obtained from healthy subjects with the rebound tonometry, non-contact airpuff tonometry, and Goldmann applanation tonometry in different age groups. Methods: A total of 180 eyes of 90 healthy subjects were included in the study. According to the subjects’ ages, the eyes were categorized into three groups: group 1 (age: 7–17 years), group 2 (age: 18–40 years), and group 3 (age: 41–75 years). Intraocular pressure was measured on each subject always in the same order: rebound tonometry, non-contact airpuff tonometry, and Goldmann applanation tonometry. Central corneal thickness values were obtained using ultrasonic pachymetry. One-way repeated-measures analysis of variance, Pearson’s correlation coefficient, and Bland–Altman analysis were used for the statistical assessment. Results: The mean corneal thickness was found to be 604 ± 13 µm, 546 ± 15 µm, and 547 ± 15 µm in group 1, group 2, and group 3, respectively. Non-contact airpuff tonometry was significantly higher than both Goldmann applanation tonometry and rebound tonometry measurements in all groups (p < 0.001, for all). No statistical difference between Goldmann applanation tonometry and rebound tonometry measurements was found in group 1 (p = 0.248), group 2 (p = 0.63), and group 3 (p = 0.126). There was a significant positive correlation in the meaning of intraocular pressure measurements between rebound tonometry and non-contact airpuff tonometry; non-contact airpuff tonometry and Goldmann applanation tonometry; and Goldmann applanation tonometry and rebound tonometry in all groups. Conclusion: As a result, without need for topical anesthesia, fast measurement and ease-of-use rebound tonometry is a reliable alternative to Goldmann applanation tonometry in different age groups.
Collapse
Affiliation(s)
- Goktug Demirci
- Department of Ophthalmology, Istanbul Medipol University, Istanbul, Turkey
| | | | - Cafer Tanriverdi
- Department of Ophthalmology, Istanbul Medipol University, Istanbul, Turkey
| | - Gokhan Gulkilik
- Department of Ophthalmology, Istanbul Medipol University, Istanbul, Turkey
| | - Mustafa Ozsutçu
- Department of Ophthalmology, Istanbul Medipol University, Istanbul, Turkey
| |
Collapse
|
16
|
Arribas-Pardo P, Mendez-Hernández C, Valls-Ferran I, Puertas-Bordallo D. Icare-Pro Rebound Tonometer Versus Hand-held Applanation Tonometer for Pediatric Screening. J Pediatr Ophthalmol Strabismus 2018; 55:382-386. [PMID: 30074606 DOI: 10.3928/01913913-20180621-01] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2017] [Accepted: 04/18/2018] [Indexed: 11/20/2022]
Abstract
PURPOSE To compare intraocular pressure (IOP) measurements obtained using the new rebound tonometer Icare-Pro (Icare, Tiolat Oy, Helsinki, Finland) and the hand-held version of the Goldmann applanation tonometer (Perkins; Clement Clarke, Haag-Streit, Harlow, United Kingdom) in healthy children during clinical practice. METHODS In this prospective study, three IOP measurements were made using each tonometer in a single session, starting with the Icare-Pro. Participants were 173 non-anesthetized patients aged 1 to 16 years. Measurements were made in both eyes but only data for the right eye were entered in the analysis. Central corneal thickness, anterior chamber depth, and axial length were also measured in each patient. Data were compared by determining interclass correlation coefficients (ICCs) for each tonometer and representing the differences detected as Bland-Altman plots. RESULTS Good linear correlation was observed between IOP readings obtained using the Perkins and Icare-Pro tonometers (r = 0.87, P < .001), although the Icare-Pro readings were slightly higher (mean IOP difference: 0.26 ± 1.58 mm Hg, P = .037). The 95% limits of agreement between the two methods were 2.8 to -3.4 mm Hg. The ICC was 0.857 (95% confidence interval: 0.810 to 0.893), indicating good agreement. For both tonometers, a low but significant correlation was detected between IOP and central corneal thickness or age. However, no correlation of IOP was found with axial length or anterior chamber depth. CONCLUSIONS Pediatric IOP measurements determined using the new Icare-Pro rebound tonometer showed good correlation with those obtained using the hand-held Perkins applanation tonometer in a routine clinical examination with no need for general anesthesia. [J Pediatr Ophthalmol Strabismus. 2018;55(6):382-386.].
Collapse
|
17
|
Heitmar R, Vekria P, Cubbidge RP. Regulation of oxygen saturation in retinal blood vessels in response to dynamic exercise. Acta Ophthalmol 2018; 96:e298-e303. [PMID: 29098810 DOI: 10.1111/aos.13576] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Accepted: 08/01/2017] [Indexed: 11/29/2022]
Abstract
PURPOSE To evaluate the impact of dynamic exercise on retinal vessel oxygen saturation in healthy individuals. METHODS Twenty-six healthy participants underwent moderate dynamic exercise (modified Master's two-step exercise). In all subjects, intraocular pressures (IOP), systolic and diastolic blood pressures (SBP and DBP), retinal vessel calibres and retinal arterial and venous oxygen saturation were measured at baseline, immediately following exercise and 15 min postexercise. RESULTS Moderate dynamic exercise increased SBP and DBP immediately postexercise (SBP: 116 (±13) mmHg to 150 (±21) mmHg; p < 0.001 and DBP: 69 (±10) mmHg to 74 (±10); p < 0.001), while IOP decreased by an average of 2 mmHg (baseline: 13 (±3) mmHg)) immediately postexercise (11 (±2) mmHg). Oxygen saturation in retinal arteries remained unchanged (baseline = 93 ± 8%; immediately postexercise = 94 ± 9% and 15 min postexercise = 96 ± 8%; p = 0.069), but increased in retinal veins immediately postexercise and did not return to baseline values within 15 min postexercise (baseline = 54 ± 12%; immediately postexercise = 56 ± 15%; 15 min postexercise=57 ± 12%; p = 0.036). CONCLUSION There is a mild increase in retinal venous oxygen saturation and there is a trend towards an increase in arterial saturation in otherwise healthy individuals following dynamic exercise.
Collapse
Affiliation(s)
- Rebekka Heitmar
- School of Life and Health Sciences; Aston University; Birmingham UK
| | - Pravin Vekria
- School of Life and Health Sciences; Aston University; Birmingham UK
| | | |
Collapse
|
18
|
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.
Collapse
|
19
|
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.
Collapse
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.
| |
Collapse
|
20
|
Kato Y, Nakakura S, Matsuo N, Yoshitomi K, Handa M, Tabuchi H, Kiuchi Y. Agreement among Goldmann applanation tonometer, iCare, and Icare PRO rebound tonometers; non-contact tonometer; and Tonopen XL in healthy elderly subjects. Int Ophthalmol 2017; 38:687-696. [PMID: 28393323 DOI: 10.1007/s10792-017-0518-2] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2016] [Accepted: 04/04/2017] [Indexed: 11/29/2022]
Abstract
PURPOSE To evaluate the inter-device agreement among the Goldmann applanation tonometer (GAT), iCare and Icare PRO rebound tonometers, non-contact tonometer (NCT), and Tonopen XL tonometer. METHODS Sixty healthy elderly subjects were enrolled. The intraocular pressure (IOP) in each subject's right eye was measured thrice using each of the five tonometers. Intra-device agreement was evaluated by calculating intraclass correlation coefficients (ICCs). Inter-device agreement was evaluated by ICC and Bland-Altman analyses. RESULTS ICCs for intra-device agreement for each tonometer were >0.8. IOP as measured by iCare (mean ± SD, 11.6 ± 2.5 mmHg) was significantly lower (p < 0.05) than that measured by GAT (14.0 ± 2.8 mmHg), NCT (13.6 ± 2.5 mmHg), Tonopen XL (13.7 ± 4.1 mmHg), and Icare PRO (12.6 ± 2.2 mmHg; Bonferroni test). There was no significant difference in mean IOP among GAT, NCT, and Tonopen XL. Regarding inter-device agreement, ICC was lower between Tonopen XL and other tonometers (all ICCs < 0.4). However, ICCs of GAT, iCare, Icare PRO, and NCT showed good agreement (0.576-0.700). The Bland-Altman analysis revealed that the width of the 95% limits of agreement was larger between the Tonopen XL and the other tonometers ranged from 14.94 to 16.47 mmHg. Among the other tonometers, however, the widths of 95% limits of agreement ranged from 7.91 to 9.24 mmHg. CONCLUSION There was good inter-device agreement among GAT, rebound tonometers, and NCT. Tonopen XL shows the worst agreement with the other tonometers; therefore, we should pay attention to its' respective IOP. CLINICAL TRIAL REGISTRATION Japan Clinical Trials Register; number: UMIN000011544.
Collapse
Affiliation(s)
- Yoshitake Kato
- Department of Ophthalmology, Saneikai Tsukazaki Hospital, 68-1 Aboshi Waku, Himeji, 671-1227, Japan
| | - Shunsuke Nakakura
- Department of Ophthalmology, Saneikai Tsukazaki Hospital, 68-1 Aboshi Waku, Himeji, 671-1227, Japan.
| | - Naoko Matsuo
- Department of Ophthalmology, Saneikai Tsukazaki Hospital, 68-1 Aboshi Waku, Himeji, 671-1227, Japan
| | - Kayo Yoshitomi
- Department of Ophthalmology, Saneikai Tsukazaki Hospital, 68-1 Aboshi Waku, Himeji, 671-1227, Japan
| | - Marina Handa
- Department of Ophthalmology, Saneikai Tsukazaki Hospital, 68-1 Aboshi Waku, Himeji, 671-1227, Japan
| | - Hitoshi Tabuchi
- 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, 1-2-3 Kasumi, Minami-Ku, Hiroshima, 734-8551, Japan
| |
Collapse
|
21
|
|
22
|
Gao F, Liu X, Zhao Q, Pan Y. Comparison of the iCare rebound tonometer and the Goldmann applanation tonometer. Exp Ther Med 2017; 13:1912-1916. [PMID: 28565785 PMCID: PMC5443276 DOI: 10.3892/etm.2017.4164] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2016] [Accepted: 02/02/2017] [Indexed: 11/05/2022] Open
Abstract
Tonometry is a fundamental procedure in routine ophthalmologic examination. Although regarded as the reference standard, the Goldmann applanation tonometer (GAT) has its limitations. A new portable alternative to the GAT is the iCare rebound tonometer (RT). The aim of the present study was to compare the intraocular pressure (IOP) results obtained using the RT and GAT and then correlate the results with the central corneal thickness (CCT). Moreover, the tolerability and safety of the RT were evaluated. The IOP of 336 patients (672 eyes) was determined by the RT and GAT. The patients were divided into three groups (group A, 7-15 mmHg, n=74; group B, 16-22 mmHg, n=218; and group C, 23-50 mmHg, n=44), based on the GAT IOP readings. Pachymetry and slit lamp inspection were also performed. To establish an agreement between the devices, a Bland-Altman analysis and paired t-test were performed. The correlation between CCT and IOP readings obtained by the two devices were assessed using linear regression correlation analysis. The mean IOP values of the RT and the GAT were 18.30±5.10 and 18.52±4.46 mmHg, respectively. There were no significant differences between them (t=-1.31, P=0.19). The 95% confidence interval of the differences between the two devices was -5.80-6.24 mmHg. The RT readings are correlated well with those of GAT (r=0.806, P=0.001). However, the RT measurements were significantly (t=-2.84, P=0.007) lower (-1.66±3.87 mmHg) than those obtained with GAT when GAT ≥23 mmHg. Both the RT (r=0.390, P=0.001) and the GAT (r=0.191, P=0.001) showed positive correlations with CCT. The IOP measurement with RT was well tolerated. None of the corneal epithelial defects was detected and all subjects denied discomfort. The RT is well tolerated and safe, and can be considered a reliable alternative to GAT for patients in a low to moderate IOP range. However, in patients with high IOP values, the measurements obtained with RT did not correlate well with those obtained by GAT. The RT readings are influenced more by CCT compared to GAT.
Collapse
Affiliation(s)
- Feng Gao
- Department of Ophthalmology, The First People's Hospital of Xiangyang, Hubei University of Medicine, Xiangyang, Hubei 441000, P.R. China
| | - Xu Liu
- Department of Ophthalmology, The First People's Hospital of Xiangyang, Hubei University of Medicine, Xiangyang, Hubei 441000, P.R. China
| | - Qing Zhao
- Department of Ophthalmology, The First People's Hospital of Xiangyang, Hubei University of Medicine, Xiangyang, Hubei 441000, P.R. China
| | - Yingzhe Pan
- Department of Ophthalmology, The First People's Hospital of Xiangyang, Hubei University of Medicine, Xiangyang, Hubei 441000, P.R. China
| |
Collapse
|
23
|
Pahlitzsch M, Brünner J, Gonnermann J, Maier AKB, Torun N, Bertelmann E, Klamann MK. Comparison of ICare and IOPen vs Goldmann applanation tonometry according to international standards 8612 in glaucoma patients. Int J Ophthalmol 2016; 9:1624-1628. [PMID: 27990366 DOI: 10.18240/ijo.2016.11.14] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2015] [Accepted: 05/16/2016] [Indexed: 11/23/2022] Open
Abstract
AIM To compare IOPen and ICare rebound tonometry to Goldmann applanation tonometry (GAT) according to International Standards Organization (ISO) 8612 criteria. METHODS Totally 191 eyes (n=107 individuals) were included. Criteria of ISO 8612 were fulfilled: 3 clusters of IOP, measured by GAT, were formed. The GAT results were given as mean±standard deviation. RESULTS GAT (19.7±0.5 mm Hg) showed a significant correlation to ICare (19.8±0.5 mm Hg) (r=0.547, P<0.001) and IOPen (19.5±0.5 mm Hg) (r=0.526, P<0.001). According to ISO 8612 criteria in all 3 IOP groups the number of outliers (of the 95% limits of agreement) exceeded 5% for ICare and IOPen vs GAT: No.1 (n=68) 29.4% and 22.1%, No.2 (n=62) 35.5% and 37.1%, No.3 (n=61) 26.2% and 42.6%, respectively. CONCLUSION The strict requirements of the ISO 8612 are not fulfilled in a glaucoma collective by ICare and IOPen at present. As long as the Goldmann tonometry is applicable it should be used first of all for reproducible IOP readings. ICare and IOPen tonometry should be considered as an alternative tool, if application of Goldmann tonometry is not possible.
Collapse
Affiliation(s)
- Milena Pahlitzsch
- Glaucoma and Retinal Degeneration Research Group, UCL, Institute of Ophthalmology, Bath Street, London, EC1V 9EL, United Kingdom
| | - Jeanette Brünner
- Department of Ophthalmology, Campus Virchow Clinic, Charite University Medicine, Augustenburger Platz 1, Berlin13353, Germany
| | - Johannes Gonnermann
- Department of Ophthalmology, Campus Virchow Clinic, Charite University Medicine, Augustenburger Platz 1, Berlin13353, Germany
| | - Anna-Karina B Maier
- Department of Ophthalmology, Campus Virchow Clinic, Charite University Medicine, Augustenburger Platz 1, Berlin13353, Germany
| | - Necip Torun
- Department of Ophthalmology, Campus Virchow Clinic, Charite University Medicine, Augustenburger Platz 1, Berlin13353, Germany
| | - Eckart Bertelmann
- Department of Ophthalmology, Campus Virchow Clinic, Charite University Medicine, Augustenburger Platz 1, Berlin13353, Germany
| | - Matthias Kj Klamann
- Department of Ophthalmology, Campus Virchow Clinic, Charite University Medicine, Augustenburger Platz 1, Berlin13353, Germany
| |
Collapse
|
24
|
Mudie LI, LaBarre S, Varadaraj V, Karakus S, Onnela J, Munoz B, Friedman DS. The Icare HOME (TA022) Study: Performance of an Intraocular Pressure Measuring Device for Self-Tonometry by Glaucoma Patients. Ophthalmology 2016; 123:1675-1684. [PMID: 27289178 DOI: 10.1016/j.ophtha.2016.04.044] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2016] [Revised: 04/22/2016] [Accepted: 04/22/2016] [Indexed: 11/24/2022] Open
Abstract
PURPOSE To evaluate the Icare HOME (TA022) device (Icare Oy, Vanda, Finland) for use by glaucoma patients for self-tonometry. DESIGN Prospective performance evaluation of a medical device. PARTICIPANTS One hundred eighty-nine participants with glaucoma or suspected glaucoma were recruited from the Wilmer Eye Institute, Baltimore, Maryland, between July 2014 and April 2015. METHODS Participants had standardized training and had to be able use the Icare HOME device independently. Subjects also had to be able to obtain the first intraocular pressure (IOP) measurement within 5 mmHg of Goldmann applanation tonometry (GAT). Those certified obtained 3 IOP measures using the HOME device, and these were compared with Icare TA01i and GAT IOP measurements. MAIN OUTCOME MEASURES The agreement between Icare HOME and reference tonometers was used to assess precision. The intraclass correlation coefficient was used to assess within-patient reliability for the HOME device. RESULTS Eighteen of 189 recruited patients were ineligible to take part in the study. Forty-four of 171 patients (25.7%) started but failed to complete the study: 7 stopped because of time concerns, 10 of 171 patients (6%) stopped because of difficulty using the device during certification, and 27 of 171 patients (16%) failed to be certified based on IOP. The HOME and GAT measurements agreed within 5 mmHg in 116 of 127 participants (91.3%); 2 participants (1.6%) had a difference of more than 7 mmHg. The mean difference between the Icare HOME and GAT measurements was -0.33 mmHg (standard deviation, 3.11 mmHg). The overall intraclass correlation coefficient for the HOME device was 0.92 (95% confidence interval, 0.89-0.95). CONCLUSIONS Not all participants could learn how to use the Icare HOME device, but for those who could, most were able to obtain measurements similar to those obtained by GAT. The Icare HOME device is safe and reliable for self-tonometry, but nearly 1 in 6 individuals may fail to certify in use of the device based on large differences in IOP when comparing GAT with the Icare HOME measurements. The device has the potential to address an unmet need by providing more frequent IOP measurements in a patient's day to day life.
Collapse
Affiliation(s)
- Lucy I Mudie
- Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland
| | - Sophie LaBarre
- Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland
| | | | - Sezen Karakus
- Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland
| | | | - Beatriz Munoz
- Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland
| | - David S Friedman
- Wilmer Eye Institute, Johns Hopkins University, Baltimore, Maryland.
| |
Collapse
|
25
|
Resende AF, Yung ES, Waisbourd M, Katz LJ. Monitoring intra ocular pressure in glaucoma: current recommendations and emerging cutting-edge technologies. EXPERT REVIEW OF OPHTHALMOLOGY 2015. [DOI: 10.1586/17469899.2015.1100539] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
|