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Swaminathan S, Kisielewski AM, Nowroozzadeh MH, Hallaj S, Lee D, Kolomeyer NN, Myers JS, Razeghinejad R. A comparison of iCare and Goldmann applanation tonometry measurements during the COVID-19 pandemic: a retrospective study. Int Ophthalmol 2024; 44:260. [PMID: 38910200 PMCID: PMC11194190 DOI: 10.1007/s10792-024-03220-8] [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: 05/02/2023] [Accepted: 06/16/2024] [Indexed: 06/25/2024]
Abstract
PURPOSE To evaluate factors associated with differences in intraocular pressure (IOP) readings between iCare and Goldmann applanation tonometry (GAT) in established glaucoma patients. METHODS This retrospective comparative study included clinical data of 350 eyes from 350 established glaucoma patients who had iCare and GAT IOP measured by an ophthalmic technician and a glaucoma specialist, respectively. The main outcome measure was the difference in IOP measurements of the right eyes with iCare and GAT. RESULTS The intraclass correlation coefficient (ICC) between GAT and iCare was 0.90. The mean IOP difference between tonometers was - 0.18 ± 2.89 mmHg. Bland-Altman plots indicated a 95% limit of agreement of - 5.8 to 5.5 mmHg. Central corneal thickness (CCT) and age were significantly correlated with the difference in IOPs of the iCare and GAT. GAT-IOP and age were significantly associated with the absolute difference in measured IOP of the two tonometers. The difference in measurements was not significantly associated with prior glaucoma surgery, average global index of optical coherence tomography, axial length, technician years of experience and certification, and IOP range. CONCLUSION Although there is good agreement between the iCare and GAT mean values, these devices are not interchangeable in glaucoma patients due to the wide range of the limit of agreement.
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Affiliation(s)
- Shreya Swaminathan
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, 19107, USA.
- Glaucoma Service, Wills Eye Hospital, 840 Walnut St, Philadelphia, PA, 19107, USA.
| | - Amber M Kisielewski
- Glaucoma Service, Wills Eye Hospital, 840 Walnut St, Philadelphia, PA, 19107, USA
| | | | - Shahin Hallaj
- Glaucoma Service, Wills Eye Hospital, 840 Walnut St, Philadelphia, PA, 19107, USA
| | - Daniel Lee
- Glaucoma Service, Wills Eye Hospital, 840 Walnut St, Philadelphia, PA, 19107, USA
| | - Natasha N Kolomeyer
- Glaucoma Service, Wills Eye Hospital, 840 Walnut St, Philadelphia, PA, 19107, USA
| | - Jonathan S Myers
- Glaucoma Service, Wills Eye Hospital, 840 Walnut St, Philadelphia, PA, 19107, USA
| | - Reza Razeghinejad
- Glaucoma Service, Wills Eye Hospital, 840 Walnut St, Philadelphia, PA, 19107, USA
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2
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Jeon S, Toh G, Park J, Lee WJ. Exploring the Feasibility of Estimating Intraocular Pressure Using Vibrational Response of the Eye: A Methodological Approach. SENSORS (BASEL, SWITZERLAND) 2024; 24:3997. [PMID: 38931781 PMCID: PMC11207738 DOI: 10.3390/s24123997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/14/2024] [Revised: 06/12/2024] [Accepted: 06/17/2024] [Indexed: 06/28/2024]
Abstract
This study addresses the limitations of current tonometry techniques by exploring vibroacoustic properties for estimating intraocular pressure (IOP), a key diagnostic parameter for monitoring glaucoma-a significant risk factor for vision loss. Utilizing vivo porcine eyeballs, we investigated the relationship between IOP and the nonlinear vibration transfer function ratio (NVTFR). Through applying varying vibration levels and analyzing responses with transfer function analysis and univariate regression, we identified a strong negative correlation between NVTFR and IOP, evidenced by a Pearson correlation coefficient of -0.8111 and significant results from generalized linear model (GLM) regression (p-value < 0.001). These findings indicate the potential of NVTFR as a vital indicator of IOP changes. Our study highlights the feasibility of using vibroacoustic properties, specifically NVTFR, to measure IOP. While further refinement is necessary for in vivo application, this approach opens new possibilities for non-invasive and patient-friendly IOP monitoring, potentially enhancing ophthalmology diagnostic techniques and providing a foundation for future research and development in this critical area.
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Affiliation(s)
- Seongwook Jeon
- Department of Mechanical Engineering, Hanyang University, Seoul 04763, Republic of Korea; (S.J.); (G.T.)
| | - Gyungmin Toh
- Department of Mechanical Engineering, Hanyang University, Seoul 04763, Republic of Korea; (S.J.); (G.T.)
| | - Junhong Park
- Department of Mechanical Engineering, Hanyang University, Seoul 04763, Republic of Korea; (S.J.); (G.T.)
| | - Won June Lee
- Department of Ophthalmology, Hanyang University College of Medicine, Seoul 04763, Republic of Korea
- Department of Ophthalmology, Hanyang University Seoul Hospital, Seoul 04763, Republic of Korea
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3
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Chaung JQ, Sangapillai T, Quilat KK, Perera S. A comparison of intraocular pressure measurement using SUOER SW-500 rebound tonometer and conventional reusable Goldmann prisms. Front Med (Lausanne) 2024; 11:1269332. [PMID: 38938385 PMCID: PMC11208312 DOI: 10.3389/fmed.2024.1269332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Accepted: 06/03/2024] [Indexed: 06/29/2024] Open
Abstract
Introduction To determine the agreement between intraocular pressure (IOP) measurements using conventional Goldmann applanation tonometry (GA1,2T) and SUOER SW-500 Rebound Tonometer. Methods This was a retrospective observational study where 205 eyes of 106 glaucoma patients had their IOPs measured by 2 fellowship trained ophthalmologists. Data were analyzed using the Bland-Altman method of differences. Correlation was measured using the Pearson coefficient. Results Most of our patients were Chinese (88.7%) and female (51.9%). The average age was 66.9 years. The range of IOPs as measured by GAT was 2 to 58 mm Hg. Using the Bland-Altman method to compare GAT and SUOER SW-500 Rebound Tonometer. The tonometer overestimated the IOP by 0.5 mm Hg in the right eye and underestimated it by 0.1 mm Hg in the left eye. Overall, the tonometer overestimated the IOP by 0.2 mmHg. The Tonometer IOP correlated well with GAT, with a Pearson coefficient of correlation(r) of 0.89 (p < 0.001) for the right eye and 0.86 (p < 0.001) for the left eye, respectively. In patients with GAT IOP ≥ 21 mm Hg (n = 25), the Tonometer underestimated the IOP by 2.96 mm Hg. Discussion The IOP measurements from the SUOER SW-500 Rebound Tonometer correlates well with the conventional GAT in measuring the IOP within normal ranges of IOP. SUOER SW-500 Rebound Tonometer may be of use, especially if the risk of transmission of infection is high considering that the probes are disposable. It is easy to use and its small size and portability makes it useful in situations where the patient is unable to be examined at the slit lamp.
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Affiliation(s)
- Jia Quan Chaung
- Singapore National Eye Centre, Singapore, Singapore
- Singapore Eye Research Institute, Singapore, Singapore
| | | | | | - Shamira Perera
- Singapore National Eye Centre, Singapore, Singapore
- Singapore Eye Research Institute, Singapore, Singapore
- Duke-NUS Medical School, Singapore, Singapore
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Kobashi H. Evaluation of a new transpalpebral tonometer for self-measuring intraocular pressure. PLoS One 2024; 19:e0302568. [PMID: 38748752 PMCID: PMC11095731 DOI: 10.1371/journal.pone.0302568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 04/07/2024] [Indexed: 05/18/2024] Open
Abstract
PURPOSE We developed a novel transpalpebral self-tonometer called the TapEye tonometer (TET) based on palpation of the upper eyelid. Our goal was to evaluate a method for improving the accuracy of measuring intraocular pressure (IOP) through the eyelid. METHODS Participants underwent standardized training by technicians and were required to be able to use the TET for study inclusion. Subsequently, a noncontact tonometer and Goldmann applanation tonometer (GAT) were used. All participants were instructed to measure their IOPs using the three tonometers at baseline (visit 1) and at 1 month (visit 2). At visit 2, the corrected IOP value measured by the TET (c-TET) was calculated using the difference between the TET and GAT measurements obtained at visit 1. RESULTS No significant correlations were found between the TET and GAT measurements at any visit, but the correlation between the c-TET and GAT measurements at visit 2 was significant. The mean difference between the c-TET and GAT measurements was 0.4 ± 3.7 mmHg in the right eye and 0.5 ± 3.4 mmHg in the left eye. CONCLUSIONS After correcting the IOP based on the difference between the TET and GAT measurements at the initial visit, the corrected IOP value of the TET was correlated with that of the GAT at the second visit. The TET has the potential to address an unmet need by providing a tool for minimally invasive IOP measurements. TRIAL REGISTRATION Clinical trial registration number: jRCTs032220268.
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Affiliation(s)
- Hidenaga Kobashi
- Toneasy Inc., Tokyo, Japan
- Department of Ophthalmology, School of Medicine, Keio University, Tokyo, Japan
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5
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Sun LW, Zhou Y, Stein JD, Weizer JS. Reliability of Intraocular Pressure Measurements in a Low-Contact Drive-Through Setting. J Glaucoma 2024; 33:24-27. [PMID: 37671557 DOI: 10.1097/ijg.0000000000002297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 08/16/2023] [Indexed: 09/07/2023]
Abstract
PRCIS Drive-through intraocular pressure (IOP) measurement using iCare tonometry is a promising method of low-contact, high-throughput IOP monitoring. However, owing to its vulnerability to variable measurement technique and local air currents, the iCare may overestimate IOPs. PURPOSE During the COVID-19 pandemic, a drive-through IOP measurement protocol using the iCare tonometer was established to facilitate low-contact monitoring of select glaucoma patients. As the iCare may be prone to error due to variable measurement technique and local air currents, we endeavored to assess the reliability of drive-through IOP measurements by comparing them with recent measurements taken in clinic settings. METHODS Inclusion criteria were patients with drive-through IOP measurements performed from April 28 to October 11, 2020; exclusion criteria were pre-drive-through IOPs >21 mmHg. Drive-through IOP measurements were compared with the closest previous and/or subsequent in-clinic IOP measurements. Data were gathered using the Sight Outcomes Research Collaborative (SOURCE) data repository. RESULTS The post-exclusion study group consisted of 314 patients receiving a total of 868 drive-through IOP measurements, all of whom had prior in-clinic measurements, and 56.8% of whom had subsequent in-clinic measurements. Drive-through IOPs were, on average, +2.4 mmHg (+14.5%; SD 4.9) higher than in-clinic IOPs. Further sub-analysis of the data showed a difference of +2.1 mmHg OD and +2.6 mmHg OS. Compared with the closest previous in-clinic visit, the difference was +2.4 mmHg OU (+2.1 mmHg OD, +2.7 mmHg OS); compared with the closest subsequent in-clinic visit, the difference was +2.3 mmHg OU (+2.1 mmHg OD, +2.5 mmHg OS). 68.6% of all drive-through IOPs were higher than corresponding in-clinic IOPs; 21.1% were lower. 25.9% of drive-through IOPs were higher by more than 5 mmHg, whereas 3.9% of drive-through IOPs were lower by more than 5 mmHg. DISCUSSION As teleophthalmology becomes an ever more important tool in glaucoma patient care, drive-through or walk-through IOP monitoring methods are likely to play an increasing role. However, our data reveals potential inaccuracies in drive-through iCare IOP measurements which tended to overestimate IOP. It is advisable to confirm large changes in IOP with in-clinic measurement before making management decisions. CONCLUSION With better optimization of accuracy and reliability of measurements, drive-through tonometry is a promising, high-throughput, low-contact method of measuring IOP.
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Affiliation(s)
- Lynn W Sun
- Department of Ophthalmology & Visual Sciences, University of Michigan Kellogg Eye Center, Ann Arbor, MI
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Yu J, Kim JY, Lee J, Park JY, Hwang JH, Oh TS, Jeong WS, Kim YK. Neck Extension and Intraocular Pressure Elevation During Palatoplasty in a Patient with Patau Syndrome and Congenital Glaucoma: A Case Report. Cleft Palate Craniofac J 2023; 60:1326-1330. [PMID: 35473400 DOI: 10.1177/10556656221097209] [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] [Indexed: 11/15/2022] Open
Abstract
Patau syndrome (trisomy 13) is a severe disorder associated with multiple systemic defects. Patau syndrome is commonly associated with ocular abnormalities but rarely associated with congenital glaucoma. To obtain a better surgical view, palatoplasty requires neck extension during surgery. The intraocular pressure (IOP) of patients with Patau syndrome can increase owing to the neck extension position while undergoing palatoplasty, particularly in those with congenital glaucoma. Here, we describe a case with increased IOP measured using a rebound tonometer during palatoplasty in a pediatric patient with Patau syndrome and congenital glaucoma. This case shows that it may be important to reduce the degree of neck extension and shorten the operation time to minimize any increase in the IOP during palatoplasty in pediatric patients with Patau syndrome accompanied by congenital glaucoma.
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Affiliation(s)
- Jihion Yu
- Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jae Yong Kim
- Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jiwoong Lee
- Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jun-Young Park
- Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jai-Hyun Hwang
- Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Tae Suk Oh
- Department of Plastic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Woo Shik Jeong
- Department of Plastic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Young-Kug Kim
- Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
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Sharfuddin Ahmed M, Ullah AY, Barman N, Ratan ZA, Mostafa S, Khaleque A, Kabir S, Khan MH, Haque MA. Risk factors associated with elevated intraocular pressure: a population-based study in a rural community of Bangladesh. BMJ Open Ophthalmol 2023; 8:e001386. [PMID: 37844969 PMCID: PMC10582991 DOI: 10.1136/bmjophth-2023-001386] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 09/25/2023] [Indexed: 10/18/2023] Open
Abstract
OBJECTIVE High intraocular pressure (IOP) is one of the major modifiable risk factors for glaucoma. The objective was to examine socio-demographic and clinical factors related to IOP. METHODS AND ANALYSIS This study was conducted among 3097 adults residing in a rural area of Bangladesh, with all participants undergoing clinical and ophthalmological evaluations. The measurement of IOP was carried out using of a rebound Tonometer called Icare pro. Multiple logistic regression analysis was employed to identify variables associated to IOP levels of 21 mm Hg or above. Adjusted OR (aOR) and 95% CI were reported. RESULTS This study found that, in total, 9% of the study population had high IOP in one or both eyes. Elevated IOP was significantly associated with respondents who were service holders (aOR 2.52; 95% CI 1.48 to 4.31), had a lower education level (aOR 1.55, 95% CI 1.07 to 2.23), used biomass fuel (aOR 2.00; 95% CI 1.09 to 3.67), belonged to a higher socioeconomic position (aOR 1.55, 95% CI 1.07 to 2.23) and had obesity (aOR 2.00; 95% CI 1.07 to 3.73), hypertension (aOR 1.32; 95% CI 1.01 to 1.73) or history of diabetes (aOR 2.44; 95% CI 1.67 to 3.55), after adjusting for covariates including age, sex, marital status, light source and tobacco consumption, in a multiple regression analysis. CONCLUSION Chronic diseases, such as hypertension and diabetes, obesity and sociodemographic characteristics such as high socioeconomic status and use of biomass fuels, have all been linked to elevated IOP. Patients with chronic diseases should undergo for IOP testing regularly.
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Affiliation(s)
- Md Sharfuddin Ahmed
- Department of Ophthalmology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | - Abm Yasin Ullah
- Department of Vitreo-Retina, National Institute of Ophthalmology and Hospital, Dhaka, Bangladesh
| | - Nilima Barman
- Department of Laboratory Medicine, Bangladesh Institute of Research and Rehabilitation of Diabetes Endocrine and Metabolic Disorders, Dhaka, Bangladesh
| | - Zubair Ahmed Ratan
- Department of Biomedical Engineering, Khulna University of Engineering and Technology, Khulna, Bangladesh
| | | | - Abdul Khaleque
- Department of Ophthalmology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | - Showkat Kabir
- Department of Ophthalmology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | - Maruf Haque Khan
- Department of Public Health and Informatics, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | - M Atiqul Haque
- Department of Public Health and Informatics, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
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8
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Sachdeva R, Iordanous Y, Lin T. Comparison of intraocular pressure measured by iCare tonometers and Goldmann applanation tonometer. CANADIAN JOURNAL OF OPHTHALMOLOGY 2023; 58:426-432. [PMID: 35809628 DOI: 10.1016/j.jcjo.2022.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 05/31/2022] [Accepted: 06/07/2022] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To evaluate the relationship between the Goldmann applanation tonometer (GAT) and the iCare PRO and iCare IC200 tonometers in measuring intraocular pressure (IOP) in adult eyes with a diagnosis of glaucoma or glaucoma suspect. PARTICIPANTS AND METHODS One hundred and one eyes from 101 participants diagnosed with glaucoma or glaucoma suspect were evaluated in this study. IOP was measured by iCare PRO and iCare IC200 tonometers in a randomized sequence followed by IOP measurements by the GAT tonometer and then central corneal thickness measurements. After the IOP measurements, participants scored their comfort level using a visual analog scale with each tonometer. Intraclass correlation coefficient (ICC) and Bland-Altman analysis were used to investigate the agreement among tonometers. SPSS and Microsoft Excel programs were used for statistical analysis. RESULTS Overall, there was good agreement among the 3 tonometers used in this study. The ICC for the iCare PRO and the iCare IC200 was 0.95 (p < 0.001), and the ICC for the iCare PRO and the GAT and the iCare IC200 and the GAT was >0.80 (p < 0.001). However, both iCare tonometers underestimated IOP by approximately 2 mm Hg compared with the GAT. Furthermore, 84% of iCare readings fall within ±5 mm Hg of GAT measurements. Neither body mass index nor central corneal thickness affected the IOP agreement among the tonometers. Participant response on visual analog scale rated IOP measurements by iCare tonometers to be more comfortable than the GAT. CONCLUSION Our results demonstrated a good agreement between iCare tonometers and GAT; but iCare tonometers underestimated IOP compared to the GAT.
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Affiliation(s)
| | | | - Tony Lin
- Department of Ophthalmology, Western University, London, Ont
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9
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Wongwanwatana S, Treesit I, Funarunart P, Iemsomboon W, Choontanom R. Intraocular pressure measurement using ICare rebound tonometer in different positions of eye and different locations on cornea. Medicine (Baltimore) 2023; 102:e34874. [PMID: 37682193 PMCID: PMC10489185 DOI: 10.1097/md.0000000000034874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 08/01/2023] [Indexed: 09/09/2023] Open
Abstract
Intraocular pressure (IOP) is one of the most crucial aspects for diagnosis and treatment plan among patients with glaucoma. Although the gold standard for IOP measurement is Goldmann applanation tonometer (GAT)[1], it must be mounted to a slit lamp biomicroscope. However, rebound tonometer has become popular due to its ease of operation and portable design, does not require topical anesthesia, and results do not differ significantly from those of GAT[2]. The purpose of this cross-sectional study is to investigate the difference in IOP measurement with iCare IC200 in different angles of the eye and different corneal locations. All participants underwent IOP measurement by GAT twice. Then, IOP was measured with iCare by a single physician. IOP was measured in a straight manner in the upright patient position; then participants were asked to look at fixation targets, which located in four different points. IOP was measured in upgaze, downgaze, medial gaze, and lateral gaze. Then, IOP was measured at 2 mm from limbus in superior, inferior, nasal, and temporal cornea. All methods were measured twice, and the mean was used for calculation. The physician who measured IOP by iCare was masked from GAT results. A total of 168 eyes were tested with a mean age of 62.15 ± 12.34 years. Mean IOP measured by GAT and iCare at the central cornea was 15.53 ± 5.57 and 14.78 ± 6.14 mmHg, respectively. The standardized mean difference (SMD) between iCare and GAT was 0.13 (-0.09-0.34), which is insignificant. The average IOP was 0.6, 0.47, 0.91, and 0.44 mmHg lower than the primary position in upgaze, downgaze, medial gaze, and lateral gaze 15 degrees angulated positions respectively (p<.01). IOPs at 2 mm from limbus in the inferior, nasal, and temporal cornea were 0.5, 0.69, and 0.57 mmHg lower than IOP measured at the central cornea (p=<.01). IOP measurements with iCare in different angles of eye were statistically significantly lower than in the primary position. Similarly, IOPs at different locations on cornea were lower than at the central cornea. However, the difference in IOP measurements with iCare in different angles of the eye and different corneal locations was in the trivial range and might be clinically insignificant.
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Affiliation(s)
- Sirada Wongwanwatana
- Department of Ophthalmology, Phramongkutklao Hospital, Phramongkutklao College of Medicine, Bangkok, Thailand
| | - Isaraporn Treesit
- Department of Ophthalmology, Phramongkutklao Hospital, Phramongkutklao College of Medicine, Bangkok, Thailand
| | - Panrapee Funarunart
- Department of Ophthalmology, Phramongkutklao Hospital, Phramongkutklao College of Medicine, Bangkok, Thailand
| | - Wallop Iemsomboon
- Department of Ophthalmology, Phramongkutklao Hospital, Phramongkutklao College of Medicine, Bangkok, Thailand
| | - Raveewan Choontanom
- Department of Ophthalmology, Phramongkutklao Hospital, Phramongkutklao College of Medicine, Bangkok, Thailand
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10
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Akkara JD, Kuriakose A. To reuse or not reuse? That is a rebound question! Indian J Ophthalmol 2023; 71:2914-2915. [PMID: 37417148 PMCID: PMC10491027 DOI: 10.4103/ijo.ijo_411_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/08/2023] Open
Affiliation(s)
- John D Akkara
- Department of Glaucoma, Chaithanya Eye Hospital and Research Institute, Kochi, Kerala, India
- Department of Glaucoma, Westend Eye Hospital, Kochi, Kerala, India
| | - Anju Kuriakose
- Department of Retina, Chaithanya Eye Hospital and Research Institute, Kochi, Kerala, India
- Department of Retina, Westend Eye Hospital, Kochi, Kerala, India
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11
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Porwal AC, Shrishrimal M, Punamia RP, Mathew BC. Assessment of intraocular pressure measurement between Goldman applanation tonometer, rebound tonometer, non-contact tonometer, and its correlation with central corneal thickness. Indian J Ophthalmol 2023; 71:1927-1931. [PMID: 37203058 PMCID: PMC10391371 DOI: 10.4103/ijo.ijo_1982_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/20/2023] Open
Abstract
Purpose To compare readings of intraocular pressure (IOP) taken with the Goldmann applanation tonometer (GAT), the non-contact tonometer (NCT), and the rebound tonometer (RBT), and to compare their correlation with central corneal thickness (CCT). Methods This was a prospective, cross-sectional, observational study to which patients above 18 years of age were enrolled. A total of 400 eyes of 200 non-glaucomatous patients underwent IOP recordings using the GAT, NCT, and RBT, and CCT was also noted. Informed consent of the patients was taken. The IOP readings taken via the three methods were compared and correlated with CCT. Paired t test was used to compare the two devices. Simple and multivariate linear regression analyses were used to study the relationship between factors. A P value less than 0.05 was considered significant. Correlation was determined using the Pearson correlation coefficient, and a Bland-Altman graph was plotted. Results Mean IOP measured by the NCT was 15.65 ± 2.80 mmHg, by the RBT was 14.23 ± 3.05 mmHg, and by the GAT was 14.69 ± 2.97 mmHg. The mean CCT was 510.61 ± 33.83 microns. The difference between mean IOP recorded by the NCT and that by the RBT was 1.41 ± 2.39 mmHg, between the NCT and GAT was 0.95 ± 2.03 mmHg, and between the GAT and RBT was 0.45 ± 2.22 mmHg. The difference between the IOP values was statistically significant (P < 0.005). All tonometers showed a statistically significant correlation with CCT, but it was observed that the NCT had a stronger correlation (0.4037). Conclusion The IOP readings taken by all the three methods were comparable; however, RBT values were closer to GAT values. CCT did influence the IOP values, and this should be kept in mind while evaluating.
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Affiliation(s)
- Amit C Porwal
- Senior Consultant Cataract and Head Glaucoma Services, Department of Cataract and Glaucoma, Choithram Netralaya, Indore, Madhya Pradesh, India
| | - Meghna Shrishrimal
- Department of Community Ophthalmology, Choithram Netralaya, Indore, Madhya Pradesh, India
| | - Ravin P Punamia
- Department of Ophthalmology, Choithram Netralaya, Indore, Madhya Pradesh, India
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Newman-Casey PA, Resnicow K, Winter S, Niziol LM, Darnley-Fisch D, Imami N, McHaney-Conner P, Musch DC, Mitchell J, Heisler M. The Support, Educate, Empower personalized glaucoma coaching trial design. Clin Trials 2023; 20:192-200. [PMID: 36855233 PMCID: PMC10023277 DOI: 10.1177/17407745221136571] [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] [Indexed: 03/02/2023]
Abstract
BACKGROUND Glaucoma is a chronic disease that affects 3 million Americans. Glaucoma is most often asymptomatic until very late in its course when treatment is more difficult and extensive peripheral vision loss has already occurred. Taking daily medications can mitigate this vision loss, but at least half of people with glaucoma do not take their prescribed medications regularly. The purpose of this study is to improve glaucoma medication adherence among those with medically treated glaucoma and poor self-reported adherence using the Support, Educate, Empower personalized coaching program. METHODS/DESIGN This study is a two-site randomized controlled trial enrolling 230 participants with poor self-reported glaucoma medication adherence. The trial has two arms, an intervention arm and a control arm. Participants in the intervention arm receive personalized glaucoma education and motivational interviewing-based coaching over 6 months from a trained non-physician interventionist for three in-person sessions with between visit phone calls for check-ins where current adherence level is reported to participants. Participants also can elect to have visual, audio, text or automated phone call medication dose reminders. Participants in the control arm continue usual care with their physician and receive non-personalized glaucoma educational materials via mail in parallel to the three in-person coaching sessions to control for glaucoma knowledge content. All participants receive a medication adherence monitor. The primary outcome is the proportion of prescribed doses taken on schedule during the 6-month period. The secondary outcome is glaucoma related distress. The exploratory outcome is intraocular pressure. DISCUSSION The personalized education and motivational-interviewing-based intervention that we are testing is comprehensive in that it addresses the wide range of barriers to adherence that people with glaucoma encounter. Leveraging a custom-built web-based application to generate the personalized content and the motivational-interviewing-based prompts to guide the coaching sessions will make this program both replicable and scalable and can be integrated into clinical care utilizing trained non-physician providers. Although this type of self-management support is not currently reimbursed for glaucoma as it is for diabetes, this trial could help shape future policy change should the intervention be found effective.
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Affiliation(s)
- Paula Anne Newman-Casey
- Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, MI, USA
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI, USA
| | - Ken Resnicow
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI, USA
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Suzanne Winter
- Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, MI, USA
| | - Leslie M Niziol
- Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, MI, USA
| | | | - Nauman Imami
- Department of Ophthalmology, Henry Ford Health System, Detroit, MI, USA
| | | | - David C Musch
- Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, MI, USA
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI, USA
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Jamie Mitchell
- School of Social Work, University of Michigan, Ann Arbor, MI, USA
| | - Michele Heisler
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI, USA
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI, USA
- Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA
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Shigemoto Y, Hasebe Y, Kitamura K, Fukuda Y, Sakamoto M, Matsubara M, Minaguchi S, Kashiwagi K. Repeated Measurements Are Necessary for Evaluating Accurate Diurnal Rhythm Using a Self-Intraocular Pressure Measurement Device. J Clin Med 2023; 12:jcm12072460. [PMID: 37048542 PMCID: PMC10094971 DOI: 10.3390/jcm12072460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 03/02/2023] [Accepted: 03/20/2023] [Indexed: 04/14/2023] Open
Abstract
PURPOSE To investigate how many tests need to be performed to adequately assess intraocular pressure (IOP) diurnal change using a self-measuring rebound tonometer among glaucoma patients. SUBJECTS AND METHODS Adult patients with primary open-angle glaucoma were included. IOP was measured in the morning (6 AM to 9 AM), afternoon (12 PM to 3 PM), and at night (6 PM to 9 PM) for seven consecutive days. Twenty-four (7 males and 17 females, mean age 59.5 ± 11.0 years) patients who successfully measured IOP at least three times per day during the correct time periods for four days were subjected to analysis. RESULTS The IOP rhythm was significantly greater on the first day of measurement (6.6 ± 3.6 mmHg) than that averaged during subsequent days (4.4 ± 2.2 mmHg). The time of the highest and lowest IOP measurements on the first day of IOP measurement and during the entire measurement period coincided in 72.9% and 64.6% of cases, respectively. The concordance rate of the highest IOP time between the whole measurement period and each measurement day was less than 60%. CONCLUSION The diurnal IOP rhythm measured by the patients themselves was not consistent, and multiple days of measurements may be necessary to correctly assess diurnal IOP rhythm.
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Affiliation(s)
- Yumi Shigemoto
- Department of Ophthalmology, Faculty of Medicine, University of Yamanashi, Yamanashi 409-3898, Japan
| | - Yuka Hasebe
- Department of Ophthalmology, Faculty of Medicine, University of Yamanashi, Yamanashi 409-3898, Japan
| | - Kazuyoshi Kitamura
- Department of Ophthalmology, Faculty of Medicine, University of Yamanashi, Yamanashi 409-3898, Japan
| | - Yoshiko Fukuda
- Department of Ophthalmology, Faculty of Medicine, University of Yamanashi, Yamanashi 409-3898, Japan
| | - Masako Sakamoto
- Department of Ophthalmology, Faculty of Medicine, University of Yamanashi, Yamanashi 409-3898, Japan
| | - Mio Matsubara
- Department of Ophthalmology, Faculty of Medicine, University of Yamanashi, Yamanashi 409-3898, Japan
| | - Shinya Minaguchi
- Department of Ophthalmology, Faculty of Medicine, University of Yamanashi, Yamanashi 409-3898, Japan
| | - Kenji Kashiwagi
- Department of Ophthalmology, Faculty of Medicine, University of Yamanashi, Yamanashi 409-3898, Japan
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Vandeurzen J, Vansteelandt K, Lemmens S, Sienaert P. Lateralized Raise in Intraocular Pressure During Electroconvulsive Therapy: A Tonometry Pilot Study. J ECT 2023; 39:42-45. [PMID: 35969842 DOI: 10.1097/yct.0000000000000879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Right unilateral ECT causes an increase in eye pressure that is partially lateralized, higher on the right side.
Objective
The aim of this study was to evaluate intraocular pressure (IOP) changes during and after electroconvulsive therapy.
Methods
In 20 patients, IOP was measured using a handheld iCare tonometer before, during, and up to 15 minutes after the seizure. Electrode placement was either right unilateral (RUL) or bilateral (BL). Statistical analyses were done at baseline, during, and 15 minutes after the seizure.
Results
In the RUL group (n = 14), the IOP in the left eye increased from 14.8 mm Hg before the seizure to 27.8 mm Hg during the seizure (P = 0.0001) and decreased to 14.0 mm Hg after the seizure (P = 0.0002). The IOP in the right eye increased from 15.4 mm Hg before the seizure to 34.4 mm Hg during the seizure (P = 0.0001) and decreased to 16.0 mm Hg after the seizure (P = 0.0002).
In the BL group (n = 6), the IOP in the left eye increased from 13.0 mm Hg before the seizure to 26.3 mm Hg during the seizure (P = 0.1250) and decreased to 14.5 mm Hg after the seizure (P = 0.250). In the right eye, the IOP increased from 13.3 mm Hg before the seizure to 28.4 mm Hg during the seizure (P = 0.1250) and decreased to 13.7 mm Hg after the seizure (P = 0.25).
When the results were compared between the 2 electrode placements, the difference in IOP between the right and left eye was higher in the RUL group during (RUL 6.7 mm Hg vs BL 2.0 mm Hg, P = 0.0231) and after (RUL 2.1 mm Hg vs BL −0.8 mm Hg, P = 0.0492) the seizure.
Conclusions
RUL stimulation with electroconvulsive therapy causes a rise in IOP that is partially lateralized, ipsilateral to the side of stimulation.
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Affiliation(s)
| | - Kristof Vansteelandt
- KU Leuven, University Psychiatric Center KU Leuven, Academic Center for ECT and Neuromodulation
| | | | - Pascal Sienaert
- KU Leuven, University Psychiatric Center KU Leuven, Academic Center for ECT and Neuromodulation
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15
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Turner M, Ou Y. At-Home Glaucoma Monitoring: Is it Ready for Prime Time? Ophthalmol Glaucoma 2023; 6:117-120. [PMID: 36184483 DOI: 10.1016/j.ogla.2022.08.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 07/28/2022] [Accepted: 08/11/2022] [Indexed: 10/14/2022]
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16
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Quérat L, Chen E. iCare® Home vs Goldmann applanation tonometry: Agreement of methods and comparison of inter-observer variation at a tertiary eye centre. Eur J Ophthalmol 2023; 33:312-318. [PMID: 35505614 PMCID: PMC9834317 DOI: 10.1177/11206721221099252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Purpose: To investigate whether the inter-observer variation is similar between the Goldmann applanation tonometer used by healthcare staff and the iCare® Home tonometer used by glaucoma patients, volunteers and healthcare staff. Methods: Sixty-one participants were recruited to the study, including 24 glaucoma patients. Seven participants were excluded. For each participant, intraocular pressure (IOP) was measured on the same occasion by two different healthcare staff using GAT as well as by a healthcare staff and the participant using the iCare® Home tonometer. Results: Seventy-two per cent of iCare® measurements were within 3 mmHg of the GAT measurements. There was a statistically significant difference between the trainers' measurements made with iCare® Home and those made with GAT (p < 0.001), as well as between the GAT measurements made by trainers and those made by extra personnel (p = 0.017). The strongest correlation was between iCare® Home participants' and trainers' measurements (0.934). The correlation between different users with GAT was lower (0.769). The inter-user agreement was excellent for iCare® Home users (95% CI 0.93, ranging from 0.880 to 0.959) and moderate for GAT users (95% CI 0.741, ranging from 0.558 to 0.849). Conclusion: Our study found that tonometry with iCare® Home has similar or less inter-user variation compared with GAT.
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Affiliation(s)
- Laurence Quérat
- Laurence Quérat, Department of Anterior Segment Disorders, St Erik Eye Hospital, Eugeniavägen 12, 171 64 Solna, Sweden.
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17
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Antonov AA, Vostrukhin SV, Volzhanin AV, Vitkov AA. [The effect of body position on the results of central and paracentral rebound tonometry]. Vestn Oftalmol 2023; 139:28-34. [PMID: 37067929 DOI: 10.17116/oftalma202313902128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/18/2023]
Abstract
PURPOSE This study analyzes the fluctuations of intraocular pressure (IOP) and clarifies the error of paracentral rebound tonometry associated with change in body position. MATERIAL AND METHODS The study included 45 healthy volunteers aged 25.4±2.1 years. First we performed rebound tonometry in the sitting position in the center of the cornea and 3-4 mm from the temporal and nasal sides (Icare-c, Icare-n, Icare-t, respectively) and bidirectional applanation tonometry (IOPcc - corneal compensated, IOPg - Goldmann tonometry). Then we measured Icare-c, Icare-n, Icare-t in the supine position, and after 5 minutes repeated Icare-c in the supine position. After this, we measured Icare-c, IOPcc and IOPg in the sitting position. RESULTS AND DISCUSSION Initial IOPcc and IOPg were 4.6±2.8 and 14.8±2.8 mm Hg. Initial Icare-c, Icare-t, and Icare-n measurements amounted to 15.0±1.9, 15.7±1.5 and 16.3±1.3 mm Hg; in the supine position the measurements were 16.4±2.1, 17.2±1.7 and 17.1±1.9 mm Hg. Paracentral measurements differed from Icare-c in both sitting and supine positions; only between Icare-t and Icare-n measured in the supine position there were no significant differences. The results of Icare-c, Icare-t, and Icare-n in body position change were comparable. Icare-c measured after 5 minutes in the supine position increased up to 16.6±2.4 mm Hg. Final IOPcc and IOPg did not differ from the initial measurements. Final Icare-c was lower than the initial result by 0.8±0.2 mm Hg, and lower than both supine Icare-c measurements by 2.1±0.2 and 2.6±0.2 mm Hg. CONCLUSION Paracentral rebound tonometry findings exceed those of rebound tonometry in central cornea, but in body position change the alteration of measurements in the same points on the cornea are comparable. In the supine position IOP increases on average by 1.0-1.5 mm Hg compared to the sitting position.
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Affiliation(s)
- A A Antonov
- Krasnov Research Institute of Eye Diseases, Moscow, Russia
| | | | - A V Volzhanin
- Krasnov Research Institute of Eye Diseases, Moscow, Russia
| | - A A Vitkov
- Krasnov Research Institute of Eye Diseases, Moscow, Russia
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Methods for measuring intraocular pressure: disadvantages and advantages. OPHTHALMOLOGY JOURNAL 2022. [DOI: 10.17816/ov106140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
This review of the literature is devoted to the comparison of tonometers based on various operating principles, their advantages and disadvantages. The principles of operation of each considered in the review tonometer are discussed. The features of the structure and mechanisms for measuring the intraocular pressure of various tonometers are highlighted, on the basis of which the anatomical features and other factors that have the greatest impact on the reliability of measurement and accounting of the data obtained in clinical practice are determined.
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Hu Y, Zeng Y, Yang J, Zeng X, Cao D, Ou B, Zhang G, Zhang L. Evaluation of short-term intraocular pressure changes after intravitreal injection of Conbercept in patients with diabetic macular edema. Front Pharmacol 2022; 13:1025205. [PMID: 36578537 PMCID: PMC9791090 DOI: 10.3389/fphar.2022.1025205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 11/30/2022] [Indexed: 12/14/2022] Open
Abstract
Background: The study concerning the influence of Conbercept, which is an anti-Vascular endothelial growth factor (VEGF) agent, in intraocular pressure (IOP) spike is limited and warrants further investigation. The current study aimed to investigate the changes of intraocular pressure after intravitreal injection (IVI) of Conbercept and evaluate the risk factors associated with intraocular pressure spikes. Methods: Patients with diabetic macular edema receiving intravitreal injection of 0.05 ml (0.5 mg) Conbercept were involved in the study. All patients underwent slit lamp examination to determine the status of phakia/pseudophakia. The axial length was measured using IOL Master 500 before intravitreal injection. Patients underwent a Conbercept intravitreal injection with a 30-gauge needle in a standard fashion. The intraocular pressure was measured 2 min before injection, and 2, 10, 30 min, 1, 2, 5, 24 h after injection using a rebound tonometer. The changes of intraocular pressure and the relevant risk factors were evaluated. Patients were subdivided into phakic group and pseudophakic group to analyze the effect of lens status on intraocular pressure changes. Results: Forty patients with a mean age of 62.48 ± 12.22 years were included in the study. The mean intraocular pressure values at baseline and 2, 10, 30 min, 1, 2, 5, 24 h after injection were 14.81 ± 3.13 mmHg, 26.80 ± 9.43 mmHg, 18.76 ± 6.16 mmHg, 16.54 ± 5.94 mmHg, 15.64 ± 3.75 mmHg, 14.46 ± 3.03 mmHg, 14.10 ± 1.88 mmHg, 14.23 ± 2.71 mmHg respectively. The intraocular pressure after injection for 2, 10 min was significantly higher than baseline (p < 0.001, p = 0.001, respectively). The intraocular pressure between baseline and post-injection for 30 min or beyond were comparable (all p > 0.05). No significant difference was found between the phakic group and pseudophakic group (p = 0.422). The changes of intraocular pressure were positively correlated with age (r = 0.329, p = 0.038), but negatively with axial length (r = -0.472, p = 0.002). Conclusion: intravitreal injection of Conbercept may cause rapid spike of intraocular pressure, but is safe with respect to short-term changes. The intraocular pressure in patients with older age and shorter axial length is more likely to be higher after intravitreal injection.
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Affiliation(s)
- Yunyan Hu
- Department of Ophthalmology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Yunkao Zeng
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Jing Yang
- Department of Ophthalmology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Xiaomin Zeng
- Department of Ophthalmology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Dan Cao
- Department of Ophthalmology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Biqun Ou
- Department of Ophthalmology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Guanrong Zhang
- Statistics Section, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China,*Correspondence: Guanrong Zhang, ; Liang Zhang,
| | - Liang Zhang
- Department of Ophthalmology, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China,School of Medicine, South China University of Technology, Guangzhou, China,*Correspondence: Guanrong Zhang, ; Liang Zhang,
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Ye Y, Yang F, Ding L, Xia F, Niu L, Wang X, Zhao J, Zhou X. Comparison of Icare HOME and non-contact tonometer in intraocular pressure measurement in the early stage after ICL V4c implantation. Eur J Ophthalmol 2022; 32:3303-3311. [PMID: 35422146 DOI: 10.1177/11206721221093990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose To investigate the characteristics of intraocular pressure (IOP) measurements using the Icare HOME rebound tonometer (RBT) and non-contact tonometer (NCT) during the early stage after implantable collamer lens (ICL) V4c implantation, and to assess the agreement between the two methods. Methods This prospective case series study included 104 eyes of 53 patients (mean age 28.77 ± 5.34 years), who underwent ICL V4c implantation. IOP was measured preoperatively, and at 0.5, 1, 2, 4, and 24 h postoperatively by Icare HOME and NCT, respectively. Results All surgeries were uneventful. IOP measurements by Icare and NCT preoperatively were 14.03 ± 2.90 mmHg and 14.09 ± 2.87 mmHg, respectively.The corresponding values were 12.56 ± 8.09 mmHg and 14.12 ± 6.52 mmHg (P > 0.05) at postoperative 0.5 h, 19.21 ± 8.74 mmHg and 19.60 ± 7.66 mmHg at postoperative 1 h (P > 0.05), 21.21 ± 8.10 mmHg and 20.31 ± 6.93 mmHg at postoperative 2 h (P > 0.05), 16.11 ± 5.89 mmHg and 17.04 ± 4.84 mmHg at postoperative 4 h (P > 0.05), and 14.04 ± 3.88 mmHg and 14.78 ± 2.80 mmHg at postoperative 24 h, respectively (P > 0.05). There was good agreement based on intraclass correlation coefficients (ICCs) between NCT and Icare HOME (all ICCs > 0.6 at different time points [range, 0.6986–0.956]). The Bland-Altman plot showed a mean percentage of over 95.81% of the points falling within the limits of agreement. There was a significant difference in the low IOP measurements (<10 mmHg) between Icare HOME and NCT (7.28 ± 2.55 vs. 10.65 ± 2.48, P < 0.001). Conclusion Icare HOME can be used for IOP measurement after ICL V4c implantation and demonstrated good agreement with NCT, except in cases with low intraocular pressure (<10 mmHg).
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Affiliation(s)
- Yuhao Ye
- Department of Ophthalmology and Optometry, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Fangwen Yang
- The second affiliated Hospital of Guizhou Medical University, Guizhou, China
| | - Lan Ding
- Department of Ophthalmology and Optometry, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Fei Xia
- Department of Ophthalmology and Optometry, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Lingling Niu
- Department of Ophthalmology and Optometry, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Xiaoying Wang
- Department of Ophthalmology and Optometry, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Jing Zhao
- Department of Ophthalmology and Optometry, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Xingtao Zhou
- Department of Ophthalmology and Optometry, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
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Oogi S, Nakakura S, Asaoka R, Terao E, Dote S, Matsuya K, Kimura Y. Case Report: Microincision Vitreous Surgery Induces Bleb Failure in Eyes With Functional Filtering Bleb. Front Med (Lausanne) 2022; 9:847660. [PMID: 35265647 PMCID: PMC8899033 DOI: 10.3389/fmed.2022.847660] [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: 01/03/2022] [Accepted: 01/26/2022] [Indexed: 11/13/2022] Open
Abstract
PurposeTo investigate the effect of microincision vitreous surgery (MIVS) on intraocular pressure (IOP) control in glaucomatous eyes with functional filtering bleb.MethodsWe enrolled 18 patients (15 males; median age, 73 years) who previously had filtering surgery and underwent MIVS with functional filtering bleb. Kaplan–Meier method was used to calculate the survival rate with defined the failure as when more number of preoperative antiglaucoma medication was started or additional glaucoma surgery including bleb revisions were performed, and IOP increase of 20% (criteria 1) and 30% (criteria 2) from preoperative levels after 2 weeks of MIVS.ResultsThe median follow-up duration was 970 days. Preoperative IOP was 13.3 ± 3.8 mmHg (mean ± SD). Postoperative IOP were 14.7 ± 4.9 (P=0.365), 15.2 ± 3.5 (P=0.137), 16.4 ± 5.6 (P = 0.073), 17.6 ± 6.1(P = 0.020), and 14.5 ± 4.0 (P = 0.402) mmHg at 3, 6, 12, and 15 months and final visit, respectively (compared to preoperative IOP). The number of antiglaucoma medications was a median of 1.0 (range 0–4) preoperatively and 0 (0–4) at the final visit (P = 0.238). The survival rates were 55%/61% at 3 months, 50%/61% at 6 months, and 38%/55% at 12 months with criteria 1 and 2, respectively. Four eyes (22%) received additional glaucoma surgery during follow-up.ConclusionAfter several months of MIVS, IOP was likely to increase. We should focus on IOP control by conducting long-term follow-ups.
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Affiliation(s)
- Satomi Oogi
- Department of Ophthalmology, Saneikai Tsukazaki Hospital, Himeji, Japan
| | - Shunsuke Nakakura
- Department of Ophthalmology, Saneikai Tsukazaki Hospital, Himeji, Japan
- *Correspondence: Shunsuke Nakakura
| | - Ryo Asaoka
- Department of Ophthalmology, Seirei Hamamatsu General Hospital, Hamamatsu, Japan
- Seirei Christopher University, Hamamatsu, Japan
- Nanovision Research Division, Research Institute of Electronics, Shizuoka University, Hamamatsu, Japan
- The Graduate School for the Creation of New Photonics Industries, Hamamatsu, Japan
- Department of Ophthalmology, Graduate School of Medicine and Faculty of Medicine, The University of Tokyo, Tokyo, Japan
| | - Etsuko Terao
- Department of Ophthalmology, Saneikai Tsukazaki Hospital, Himeji, Japan
| | - Saki Dote
- Department of Ophthalmology, Saneikai Tsukazaki Hospital, Himeji, Japan
| | - Kanae Matsuya
- Department of Ophthalmology, Saneikai Tsukazaki Hospital, Himeji, Japan
| | - Yui Kimura
- Department of Ophthalmology, Saneikai Tsukazaki Hospital, Himeji, Japan
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Lubbad A, Oluwatoba-Popoola I, Haar M, Framme C, Bajor A. The influence of corneal density and thickness on tonometry measurement with goldmann applanation, non-contact and iCare tonometry methods. Int Ophthalmol 2022; 42:2167-2174. [PMID: 35023013 PMCID: PMC9287215 DOI: 10.1007/s10792-022-02216-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 01/03/2022] [Indexed: 11/25/2022]
Abstract
PURPOSE To evaluate the effect of corneal density and thickness on the accuracy of tonometry readings obtained via three most used techniques. METHOD Intraocular pressures of 45 patients' right eyes were measured using Goldmann Applanation, iCare, and non-contact tonometry methods. Corneal parameters were obtained using the Pentacam Camera System. Data obtained were analyzed using Paired t Test, Pearson's correlation coefficient, multiple linear regression analysis, and Bland-Altman plots. RESULTS The mean corneal thickness was 545.4 ± 3.93 μm. The mean corneal density of total, stromal, 0-2 mm, and 2-6 mm zones were 27.85 ± 6.23 GSU, 24.61 ± 6.05 GSU, 20.76 ± 2.96 GSU, and 20.81 ± 3.51 GSU respectively. IOP readings had a statistically significant correlation with corneal stromal thickness, as well as with total and stromal density. The stromal density, however, showed higher correlation with the three tonometry methods than did the total density (iCare: - .482 (0.001) stromal density versus- .464 (0.001) total density, NCT: - .376 (0.011) versus - .353 (0.017), GAT: - .306 (0.041) versus - .296 (0.048)). Statistical differences were found in comparing the iCare readings with GAT (P < 0,00) and with NCT (P < 0,00), with mean differences of 1.8 mmHg ± 2.6 and 2.0 mmHg ± 2.6 respectively. GAT and NCT measurements showed no statistical difference (P > 0.05). CONCLUSION This study shows that both central corneal thickness and stromal density are significant influential factors of reliable IOP readings. It is necessary to consider more corneal biomechanical properties, as well as exercise a high degree of caution in any new attempts towards adjusting an IOP-correction equation.
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Affiliation(s)
- Ahmed Lubbad
- Clinic for Ophthalmology, Hannover Medical School, Hannover, Germany.
- , Carl-Neuberg-Str. 1, 30625, Hannover, Germany.
| | | | - Melanie Haar
- Clinic for Ophthalmology, Hannover Medical School, Hannover, Germany
| | - Carsten Framme
- Clinic for Ophthalmology, Hannover Medical School, Hannover, Germany
| | - Anna Bajor
- Clinic for Ophthalmology, Hannover Medical School, Hannover, Germany
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23
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Pirlich N, Grehn F, Mohnke K, Maucher K, Schuster A, Wittenmeier E, Schmidtmann I, Hoffmann EM. Anaesthetic protocol for paediatric glaucoma examinations: the prospective EyeBIS Study protocol. BMJ Open 2021; 11:e045906. [PMID: 34610927 PMCID: PMC8493900 DOI: 10.1136/bmjopen-2020-045906] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Neonates and young infants with diagnosed or highly suspected glaucoma require an examination under anaesthesia to achieve accurate intraocular pressure (IOP) measurements, since crying or squinting of the eyes may increase IOP and lead to falsely high values. IOP considerably depends on perioperative variables such as haemodynamic factors, anaesthetics, depth of anaesthesia and airway management. The aim of this paper is to report the design and baseline characteristics of EyeBIS, which is a study to develop a standardised anaesthetic protocol for the measurement of IOP under anaesthesia in childhood glaucoma, by investigating the link between the magnitude of IOP and depth of anaesthesia. METHODS AND ANALYSIS This is a single-centre, prospective cohort study in 100 children with diagnosed or highly suspected glaucoma all undergoing ophthalmological examination under general anaesthesia. 20 children, who undergo general anaesthesia for other reasons, are included as controls. The primary outcome measure is the establishment of a standardised anaesthetic protocol for IOP measurement in childhood glaucoma by assessing the relationship between IOP and depth of anaesthesia (calculated as an electroencephalography variable, the bispectral index), with special emphasis on airway management and haemodynamic parameters. The dependence of IOP under anaesthesia on airway management and haemodynamic parameters will be described, using a mixed linear model. Restricting the model to patients with healthy eyes will allow to determine a 95% reference region, in which 95% of the measurement values of patients with healthy eyes can be expected. ETHICS AND DISSEMINATION The study has been approved by the local ethics committee of the Medical Association of Rhineland-Palatine (Ethik-Kommisssion der Landesaerztekammer Rheinland-Pfalz), Germany (approval number: 2019-14207). This work will be disseminated by publication of peer-reviewed manuscripts, presentation in abstract form at national and international scientific meetings and data sharing with other investigators. TRIAL REGISTRATION NUMBER ClinicalTrials.gov Registry (NCT03972852).
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Affiliation(s)
- Nina Pirlich
- Department of Anaesthesiology, University Medical Centre of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Franz Grehn
- Department of Ophthalmology, University Medical Centre of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Katja Mohnke
- Department of Anaesthesiology, University Medical Centre of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Konrad Maucher
- Department of Anaesthesiology, University Medical Centre of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Alexander Schuster
- Department of Ophthalmology, University Medical Centre of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Eva Wittenmeier
- Department of Anaesthesiology, University Medical Centre of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Irene Schmidtmann
- Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Centre of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Esther M Hoffmann
- Department of Ophthalmology, University Medical Centre of the Johannes Gutenberg University Mainz, Mainz, Germany
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24
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Different Effects of Aging on Intraocular Pressures Measured by Three Different Tonometers. J Clin Med 2021; 10:jcm10184202. [PMID: 34575313 PMCID: PMC8471438 DOI: 10.3390/jcm10184202] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 09/14/2021] [Accepted: 09/15/2021] [Indexed: 11/17/2022] Open
Abstract
This study aimed to compare intraocular pressures (IOP) using different tonometers, Goldmann applanation (IOPGAT), non-contact (IOPNCT), and rebound (IOPRBT), and to assess the effects of aging and central corneal thickness (CCT) on the measurements. The IOPGAT, IOPNCT, IOPRBT, mean patient age (65.1 ± 16.2 years), and CCT (521.7 ± 39.2 µm) were collected retrospectively from 1054 eyes. The differences among IOPs were compared by the paired t-test. Possible correlations between devices, age, and CCT were assessed by linear regression analyses. The effects of age and CCT on the IOP reading were assessed by mixed-effects regression models. The IOPGAT values were 2.4 and 1.4 mmHg higher than IOPNCT and IOPRBT, respectively; the IOPNCT was 1.0 mmHg lower than IOPRBT (p < 0.0001 for all comparisons). The IOPs measured by each tonometer were highly correlated with each other (r = 0.81–0.90, t = 45.2–65.5). The linear regression analyses showed that age was negatively correlated with IOPNCT (r = −0.12, t = −4.0) and IOPRBT (r = −0.14, t = −4.5) but not IOPGAT (r = 0.00, t = −0.2); the CCT was positively correlated with IOPGAT (r = 0.13, t = 4.3), IOPNCT (r = 0.29, t = 9.8), and IOPRBT (r = 0.22, t = 7.2). The mixed-effect regression models showed significant negative correlations between age and IOPNCT (t = −2.6) and IOPRBT (t = −3.4), no correlation between age and IOPGAT (t = 0.2), and a significant positive correlation between CCT and the tonometers (t = 3.4–7.3). No differences between IOPGAT and IOPRBT were seen at the age of 38.8 years. CCT affects IOPs from all tonometers; age affects IOPNCT and IOPRBT in different degrees. IOPRBT tended to be higher than IOPGAT in young subjects, but this stabilized in middle age and became higher in older subjects.
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25
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Sakata R, Fujishiro T, Saito H, Nakamura N, Honjo M, Shirato S, Miyamoto E, Yamada Y, Aihara M. Recovery of deepening of the upper eyelid sulcus after switching from prostaglandin FP receptor agonists to EP2 receptor agonist: a 3-month prospective analysis. Jpn J Ophthalmol 2021; 65:591-597. [PMID: 34283308 DOI: 10.1007/s10384-021-00855-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Accepted: 05/28/2021] [Indexed: 11/28/2022]
Abstract
PURPOSE To examine the effect of switching from a prostanoid FP receptor agonists to EP2 receptor agonist (omidenepag isopropyl) on the deepening of the upper eyelid sulcus (DUES) and intraocular pressure (IOP) in Japanese glaucoma patients over 3 months post treatment. STUDY DESIGN Prospective observational study. METHODS Patients with glaucoma who received FP receptor agonists treatment and had complained of DUES-related reduction in quality of life were included. Their FP receptor agonists was switched to omidenepag isopropyl without a drug holiday. At baseline and 1 and 3 months post-switch, photographs were taken and the changes in DUES were assessed by three independent observers. IOP and adverse events were also assessed. RESULTS The study included 23 eyes of 23 patients (6 men, 17 women; average age, 60.6 years). After switching, DUES improved in 12 eyes at 1 month and in 16 eyes at 3 months; eyes in the remaining patients showed no worsening of the condition. The mean IOP before switching was 15.3 ± 3.3 mmHg (95% confidence interval 13.9-16.7 mmHg). Following the switch, the mean IOP values were 15.6 ± 3.3 mmHg (14.1-17.0 mmHg) at 1 month and 15.5 ± 3.3 mmHg (14.1-16.9 mmHg) at 3 months (P = 1.0 at 1 month, P = 1.0 at 3 months; both adjusted by Bonferroni correction). No adverse effects were observed. CONCLUSION Omidenepag isopropyl improved DUES while maintaining IOP in over 70% of Japanese patients with glaucoma who exhibited DUES caused by FP receptor agonists; the improvement was observed within 3 months after switching from FP receptor agonists.
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Affiliation(s)
- Rei Sakata
- Department of Ophthalmology, Graduate of Medicine and Faculty of Medicine, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan. .,Yotsuya Shirato Eye Clinic, Tokyo, Japan.
| | - Takashi Fujishiro
- Department of Ophthalmology, Graduate of Medicine and Faculty of Medicine, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.,Yotsuya Shirato Eye Clinic, Tokyo, Japan
| | - Hitomi Saito
- Department of Ophthalmology, Graduate of Medicine and Faculty of Medicine, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.,Yotsuya Shirato Eye Clinic, Tokyo, Japan
| | - Natsuko Nakamura
- Department of Ophthalmology, Graduate of Medicine and Faculty of Medicine, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan
| | - Megumi Honjo
- Department of Ophthalmology, Graduate of Medicine and Faculty of Medicine, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.,Yotsuya Shirato Eye Clinic, Tokyo, Japan
| | | | | | | | - Makoto Aihara
- Department of Ophthalmology, Graduate of Medicine and Faculty of Medicine, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.,Yotsuya Shirato Eye Clinic, Tokyo, Japan
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26
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Nakakura S, Asaoka R, Terao E, Nagata Y, Fukuma Y, Oogi S, Shiraishi M, Kiuchi Y. Evaluation of rebound tonometer iCare IC200 as compared with IcarePRO and Goldmann applanation tonometer in patients with glaucoma. EYE AND VISION 2021; 8:25. [PMID: 34193284 PMCID: PMC8247177 DOI: 10.1186/s40662-021-00249-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 05/28/2021] [Indexed: 11/10/2022]
Abstract
Background This study investigated the agreement between a new rebound tonometer, IC200, and IcarePRO and Goldmann applanation tonometry (GAT). Methods This was a prospective cross-sectional study. We measured the intraocular pressure (IOP) in 145 eyes of 145 glaucoma patients in the sitting position using GAT, IcarePRO, and IC200. IcarePRO and IC200 measurements were also obtained in the supine position. IC200 measurement was performed using two modes: single six (IC200-single) and automatic (IC200-continuous) six-measurements mode. Results All tonometers provided high reproducibility in both positions (all intraclass correlation coefficients > 0.90), although it was highest with GAT, followed by IC200-continuous and IC200-single and then IcarePRO. In the sitting position, the mean (± SD) IOPs of GAT, IcarePRO, IC200-single, and IC200-continuous were 14.5 ± 2.9 mmHg, 13.3 ± 3.2 mmHg, 11.6 ± 3.2 mmHg, and 11.5 ± 3.2 mmHg, respectively. IOPs measured with IcarePRO or IC200 were significantly lower than those with GAT, particularly in patients with low IOP. IOPs measured with all tonometers were significantly elevated in the supine position as compared with the sitting position, but this difference was significantly greater with IC200-single and IC200-continuous compared with IcarePRO. IOP elevation was significant in eyes without bleb versus those with bleb, but this finding was not observed when IOP was measured with IcarePRO. The IOPs of the single and continuous modes of IC200 were interchangeable in both positions. Conclusions GAT, IcarePRO, and IC200 had sufficiently high reproducibility, but measurements with IcarePRO may not be accurate in the supine position. Elevation of IOP in the supine position, especially in eyes with bleb, was more sensitively captured with IC200 than with IcarePRO. Trial registration Japan Clinical Trials Register, No. UMIN000039982. Supplementary Information The online version contains supplementary material available at 10.1186/s40662-021-00249-z.
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Affiliation(s)
- Shunsuke Nakakura
- Department of Ophthalmology, Saneikai Tsukazaki Hospital, 68-1 Aboshi Waku, Himeji, 671-1227, Japan.
| | - Ryo Asaoka
- Department of Ophthalmology, Seirei Hamamatsu General Hospital, Hamamatsu, Shizuoka, Japan. .,Seirei Christopher University, Hamamatsu, Shizuoka, Japan.
| | - Etsuko Terao
- Department of Ophthalmology, Saneikai Tsukazaki Hospital, 68-1 Aboshi Waku, Himeji, 671-1227, Japan
| | - Yuki Nagata
- Department of Ophthalmology, Saneikai Tsukazaki Hospital, 68-1 Aboshi Waku, Himeji, 671-1227, Japan
| | - Yasuko Fukuma
- Department of Ophthalmology, Saneikai Tsukazaki Hospital, 68-1 Aboshi Waku, Himeji, 671-1227, Japan
| | - Satomi Oogi
- Department of Ophthalmology, Saneikai Tsukazaki Hospital, 68-1 Aboshi Waku, Himeji, 671-1227, Japan
| | - Miku Shiraishi
- Department of Ophthalmology, Saneikai Tsukazaki Hospital, 68-1 Aboshi Waku, Himeji, 671-1227, Japan
| | - Yoshiaki Kiuchi
- Department of Ophthalmology and Visual Sciences, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan
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Greenwald SH, Macias BR, Lee SMC, Marshall-Goebel K, Ebert DJ, Liu JHK, Ploutz-Snyder RJ, Alferova IV, Dulchavsky SA, Hargens AR, Stenger MB, Laurie SS. Intraocular pressure and choroidal thickness respond differently to lower body negative pressure during spaceflight. J Appl Physiol (1985) 2021; 131:613-620. [PMID: 34166098 DOI: 10.1152/japplphysiol.01040.2020] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Spaceflight-associated neuro-ocular syndrome (SANS) develops during long-duration (>1 mo) spaceflight presumably because of chronic exposure to a headward fluid shift that occurs in weightlessness. We aimed to determine whether reversing this headward fluid shift with acute application of lower body negative pressure (LBNP) can influence outcome measures at the eye. Intraocular pressure (IOP) and subfoveal choroidal thickness were therefore evaluated by tonometry and optical coherence tomography (OCT), respectively, in 14 International Space Station crewmembers before flight in the seated, supine, and 15° head-down tilt (HDT) postures and during spaceflight, without and with application of 25 mmHg LBNP. IOP in the preflight seated posture was 14.4 mmHg (95% CI, 13.5-15.2 mmHg), and spaceflight elevated this value by 1.3 mmHg (95% CI, 0.7-1.8 mmHg, P < 0.001). Acute exposure to LBNP during spaceflight reduced IOP to 14.2 mmHg (95% CI, 13.4-15.0 mmHg), which was equivalent to that of the seated posture (P > 0.99), indicating that venous fluid redistribution by LBNP can influence ocular outcome variables during spaceflight. Choroidal thickness during spaceflight (374 µm, 95% CI, 325-423 µm) increased by 35 µm (95% CI, 25-45 µm, P < 0.001), compared with the preflight seated posture (339 µm, 95% CI, 289-388 µm). Acute use of LBNP during spaceflight did not affect choroidal thickness (381 µm, 95% CI, 331-430 µm, P = 0.99). The finding that transmission of reduced venous pressure by LBNP did not decrease choroidal thickness suggests that engorgement of this tissue during spaceflight may reflect changes that are secondary to the chronic cerebral venous congestion associated with spaceflight.NEW & NOTEWORTHY Spaceflight induces a chronic headward fluid shift that is believed to underlie ocular changes observed in astronauts. The present study demonstrates, for the first time, that reversing this headward fluid shift via application of lower body negative pressure (LBNP) during spaceflight may alter the ocular venous system, as evidenced by a decrease in intraocular pressure. This finding indicates that LBNP has the potential to be an effective countermeasure against the headward fluid shift during spaceflight, which may then be beneficial in preventing or reversing associated ocular changes.
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Affiliation(s)
| | - Brandon R Macias
- National Aeronautics and Space Administration, Johnson Space Center, Houston, Texas
| | | | | | | | - John H K Liu
- Shiley Eye Institute, University of California, San Diego, California
| | - Robert J Ploutz-Snyder
- Applied Biostatistics Laboratory, School of Nursing, University of Michigan, Ann Arbor, Michigan
| | - Irina V Alferova
- Russian Federation State Research Center Institute of Biomedical Problems, Russian Academy of Sciences, Moscow, Russia
| | | | - Alan R Hargens
- Altman Clinical and Translational Research Institute, University of California, San Diego, California
| | - Michael B Stenger
- National Aeronautics and Space Administration, Johnson Space Center, Houston, Texas
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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.
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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.
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De Arrigunaga S, Aziz K, Lorch AC, Friedman DS, Armstrong GW. A Review of Ophthalmic Telemedicine for Emergency Department Settings. Semin Ophthalmol 2021; 37:83-90. [PMID: 34027803 DOI: 10.1080/08820538.2021.1922712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Patients presenting to emergency departments for ophthalmic emergencies benefit from prompt evaluation. However, Few emergency departments (EDs) have ophthalmologists on call, and eye care provided in EDs without ophthalmic services can be inaccurate. METHODS We review the current state of ophthalmic telemedical care in EDs and highlight important considerations when implementing telemedicine in this setting. RESULTS Telemedicine allows ophthalmologists to work with on-site emergency care providers to interview and examine patients remotely in EDs, enabling proper assessment of patient history, visual acuity, pupils, intraocular pressure, as well as the anterior and posterior segment. To date, patients' perceptions of this new model of care have been largely positive. DISCUSSION The use of telemedical consultations for remote evaluation of patients with ophthalmic complaints stands to improve the quality of care provided to patients and extend the reach of remote ophthalmologists. The onset of the COVID-19 pandemic and the risk of in-person care further highlights the potential for telemedicine to augment existing models of emergency care.
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Affiliation(s)
| | - Kanza Aziz
- Department of Ophthalmology, Wilmer Eye Institute, Baltimore, MD, USA
| | - Alice C Lorch
- Department of Ophthalmology, Massachusetts Eye and Ear, Boston, MA, USA
| | - David S Friedman
- Department of Ophthalmology, Massachusetts Eye and Ear, Boston, MA, USA
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30
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Tan BH, Young A, Bianchi E, Brown L, Tatham AJ. Fluctuation in Blood Pressure and Intraocular Pressure in Normal Tension Glaucoma Using Ambulatory Monitoring. J Glaucoma 2021; 30:304-311. [PMID: 33394843 DOI: 10.1097/ijg.0000000000001768] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 11/25/2020] [Indexed: 11/25/2022]
Abstract
PRCIS Ambulatory blood pressure (BP) and intraocular pressure (IOP) monitoring of patients with normal tension glaucoma (NTG) revealed features of vascular dysregulation including hypertension, blunted nocturnal BP dipping, and morning BP surge. PURPOSE The aim was to examine ambulatory fluctuations in IOP and BP in patients with NTG. METHODS A prospective study of 45 participants with NTG and 10 controls. All participants had a comprehensive ophthalmological examination followed by glaucoma medication washout. Patients using systemic antihypertensives were excluded. IOP and BP were recorded using home monitoring over 48 hours using a self-rebound tonometer and ambulatory blood pressure monitor. BP was recorded every 30 minutes by day and every 60 minutes overnight. IOP was recorded at 09:00, 11:00, 13:00, 16:00, 20:00, and 04:00. RESULTS Participants with NTG had a median mean deviation (MD) of -4.66 dB (interquartile range: -7.16 to -2.81 dB) in the worse eye. Among those with glaucoma, 18 of 45 (40%) had normal nocturnal BP dipping, 24 (53%) blunted dipping and 3 (6.7%) exaggerated dipping. Each 10 mm Hg lower minimum sleeping systolic BP was associated with a 0.9 dB (95% confidence interval: 0.1-1.6 dB) worse MD. Sixteen of 45 participants with glaucoma (35.6%) and 1 of 10 controls (10%) were found to have systemic hypertension on ambulatory blood pressure monitoring and 32 of those with glaucoma (71%) had a surge in morning BP, compared with 5 controls (50%). There was no difference in MD between patients with normal, exaggerated and blunted dipping (P=0.813). CONCLUSIONS Though glaucoma has been associated with exaggerated nocturnal BP dipping, we found a higher proportion of patients had systemic hypertension, blunted nocturnal BP dipping, and a morning BP surge, measures also associated with vascular dysregulation.
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Affiliation(s)
- Boo Hui Tan
- Princess Alexandra Eye Pavilion
- University of Edinburgh, Edinburgh, UK
| | - Alexandra Young
- Princess Alexandra Eye Pavilion
- University of Edinburgh, Edinburgh, UK
| | - Eleonora Bianchi
- Princess Alexandra Eye Pavilion
- University of Edinburgh, Edinburgh, UK
| | - Lyndsay Brown
- Princess Alexandra Eye Pavilion
- University of Edinburgh, Edinburgh, UK
| | - Andrew J Tatham
- Princess Alexandra Eye Pavilion
- University of Edinburgh, Edinburgh, UK
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31
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Angmo D, Ramesh P, Mahalingam K, Azmira K, Pandey S, Gupta V, Sihota R, Dada T. Comparative Evaluation of Rebound and Perkins Tonometers in Pediatric Glaucoma With Varied Corneal Characteristics. J Glaucoma 2021; 30:312-316. [PMID: 33399355 DOI: 10.1097/ijg.0000000000001765] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Accepted: 11/21/2020] [Indexed: 11/25/2022]
Abstract
PRECIS Icare tonometer overestimated intraocular pressure (IOP) as compared with Perkins and this variation was higher in IOP>19 mm Hg and corneal opacity in patients with pediatric glaucoma. PURPOSE To compare the IOP measured by Icare ic200 with Perkins tonometer in pediatric glaucoma with different corneal characteristics. METHODS Patients of pediatric glaucoma posted for routine examination under anesthesia, age below 12 years were enrolled. All patients underwent IOP measurement with Perkins and Icare ic200 tonometer by the same observer. Basic demographic data and other relevant clinical data were recorded. Central corneal thickness (CCT), horizontal corneal diameter, and corneal characteristics such as cornea clarity was recorded. RESULTS A total of 194 eyes of 105 patients were analyzed. The difference between Perkins and Icare IOP was -0.816 mm Hg with the Bland-Altman plot 95% limits of agreement (LoA) from -11.194 to 9.562 mm Hg and 5.1% (10) values lying outside LoA. At IOP <19 mm Hg, the difference was -0.65 mm Hg and IOP ≥19 mm Hg, the difference was higher, -1.12 mm Hg. In the clear cornea group (123 eyes), the difference in IOP by 2 tonometers was -0.776 mm Hg with the Bland-Altman plot 95% LoA between -10.679 and 9.128 mm Hg. In hazy corneas (36 eyes), the difference in IOP was 0.531 mm Hg. The Bland-Altman plot showed 95% LoA between -6.242 and 7.303 mm Hg. In the scarred cornea group (35 eyes), the difference in IOP between the 2 was -2.343 mm Hg and the Bland-Altman plot showed wide 95% LoA from -16.302 to 11.616 mm Hg. CONCLUSION Icare tonometer overestimated IOP as compared with Perkins and this variation was higher in eyes with IOP≥19 mm Hg, CCT >615 μm, and scarred corneas. A moderate correlation between IOP and CCT for both tonometers was noted.
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Affiliation(s)
- Dewang Angmo
- Dr Rajendra Prasad Centre for Ophthalmic Sciences
| | | | | | | | - Shivam Pandey
- Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India
| | - Viney Gupta
- Dr Rajendra Prasad Centre for Ophthalmic Sciences
| | | | - Tanuj Dada
- Dr Rajendra Prasad Centre for Ophthalmic Sciences
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Abstract
Technological advances provide a number of options for glaucoma monitoring outside the office setting, including home-based tonometry and perimetry. This has the potential to revolutionize management of this chronic disease, improve access to care, and enhance patient engagement. Here, we provide an overview of existing technologies for home-based glaucoma monitoring. We also discuss areas for future research and the potential applications of these technologies to telemedicine, which has been brought to the forefront during the ongoing COVID-19 pandemic.
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Affiliation(s)
- Inas F Aboobakar
- Department of Ophthalmology , Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA
| | - David S Friedman
- Department of Ophthalmology , Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA
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33
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Borroni D, Gadhvi KA, Hristova R, McLean K, Rocha de Lossada C, Romano V, Kaye S. Influence of Corneal Visualization Scheimpflug Technology Tonometry on Intraocular Pressure. OPHTHALMOLOGY SCIENCE 2021; 1:100003. [PMID: 36246003 PMCID: PMC9562332 DOI: 10.1016/j.xops.2021.100003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 12/28/2020] [Accepted: 01/07/2021] [Indexed: 11/25/2022]
Abstract
Purpose To investigate the effect of Corneal Visualization Scheimpflug Technology tonometry (CST) on intraocular pressure (IOP). Design Cohort study. Participants Patients with and without primary open-angle glaucoma (POAG) were included. Methods Intraocular pressure was measured using the Icare rebound tonometer (ICRT; Icare Finland Oy) and the biomechanically corrected IOP (bIOP) using the CST. Intraocular pressure was measured at baseline with ICRT, followed by a CST measurement in one eye with the fellow eye acting as a control. Icare measurements were repeated at 10 seconds and 1, 2, 4, 8, 15, 30, and 60 minutes in both eyes. The ratio of test eye IOP to fellow eye IOP was used to control for intrasubject variation. Main Outcome Measures Intraocular pressure change following Corneal Visualization Scheimflug Technology tonometry. Results Forty participants (mean age, 54.09 ± 20.08 years) were included comprising 20 patients with POAG and 20 patients with no ocular abnormalities other than cataract. Mean central corneal thickness was similar in those without POAG (547.4 ± 55.05 μm) and with POAG (520.22 ± 37.59 μm; P = 0.14). No significant change was found in IOP measured with the ICRT in the fellow eye versus the 1-hour period in either the healthy (P = 0.87) or POAG (P = 0.92) group. Significant changes were found in IOP after CST measurement for both healthy (P < 0.01) and glaucomatous (P < 0.01) eyes. After the CST measurement, the IOP reduced continuously from a mean of 13.75 mmHg to 10.84 mmHg at 4 minutes for healthy eyes and from 13.28 mmHg to 11.11 mmHg at 8 minutes for glaucomatous eyes before approaching (83% for healthy eyes and 92% POAG eyes) the pre-CST measurement at 1 hour. Conclusions Corneal Visualization Scheimpflug Technology tonometry causes a significant reduction in IOP in both glaucomatous and healthy eyes that lasts for at least 1 hour afterward.
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Campbell P, Edgar DF, Shah R. Inter-optometrist variability of IOP measurement for modern tonometers and their agreement with Goldmann Applanation Tonometry. Clin Exp Optom 2021; 104:602-610. [DOI: 10.1080/08164622.2021.1878831] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Affiliation(s)
- Peter Campbell
- Division of Optometry and Visual Sciences, School of Health Sciences, City, University of London, London, UK
- Department of Ophthalmology, Guy’s and St Thomas’ NHS Foundation Trust, London, UK
| | - David F Edgar
- Division of Optometry and Visual Sciences, School of Health Sciences, City, University of London, London, UK
| | - Rakhee Shah
- Division of Optometry and Visual Sciences, School of Health Sciences, City, University of London, London, UK
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Kim D, Chung Y, Yeon Y, Cho H, Lim HW, Park J, Lee WJ. A pilot study for intraocular pressure measurements based on vibroacoustic parameters. Sci Rep 2021; 11:1264. [PMID: 33441815 PMCID: PMC7806898 DOI: 10.1038/s41598-020-80321-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 12/15/2020] [Indexed: 02/01/2023] Open
Abstract
The present study aimed to identify vibroacoustic properties associated with intraocular pressure (IOP) changes and to suggest a new way to measure the IOP based on these properties. Ten ex vivo porcine eyeballs were used in this study. Each eyeball was fixated in a central hole of a Styrofoam block, and vibration applied to the Styrofoam block was transmitted to the eyeball. An accelerometer directly attached to the eyeball measured the vibration response. Excitations and measurements were performed for 1 s, and the excitation magnitude was varied for the same signal in repeat measurements. A 30-gauge needle was inserted into the anterior chamber of the eyeball to inject a balanced salt solution, and the height of the bottle was adjusted to adjust the IOP. A tonometer was used under identical conditions to measure the IOP five times, and the mean value was determined for further analyses. The measurements showed that the parameters resonance frequency and change in the magnitude of the vibration response (CMVR) increased with rising IOP values. The CMVR was highly correlated with the IOP (p-value < 0.0001). A linear mixed effects model (LMM) was used as a statistical analysis method. We confirmed that vibroacoustic properties of the eyeball are correlated with IOP changes. It is expected that the CMVR will serve as a new parameter for IOP measurements. Thus, in the future, continuous IOP measurements would be easily performed using the CMVR.
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Affiliation(s)
- Deukha Kim
- Department of Mechanical Engineering, Hanyang University College of Engineering, Seoul, Korea
| | - Youngbeen Chung
- Department of Mechanical Engineering, Hanyang University College of Engineering, Seoul, Korea
| | - Yeji Yeon
- Department of Ophthalmology, Hanyang University College of Medicine, Wangsimni-ro 222, Seongdong-gu, Seoul, 04763, Korea
| | - Hyunsoo Cho
- Department of Ophthalmology, Hanyang University College of Medicine, Wangsimni-ro 222, Seongdong-gu, Seoul, 04763, Korea
| | - Han Woong Lim
- Department of Ophthalmology, Hanyang University College of Medicine, Wangsimni-ro 222, Seongdong-gu, Seoul, 04763, Korea.,Department of Ophthalmology, Hanyang University Seoul Hospital, Wangsimni-ro 222, Seongdong-gu, Seoul, 04763, Korea
| | - Junhong Park
- Department of Mechanical Engineering, Hanyang University College of Engineering, Seoul, Korea
| | - Won June Lee
- Department of Ophthalmology, Hanyang University College of Medicine, Wangsimni-ro 222, Seongdong-gu, Seoul, 04763, Korea. .,Department of Ophthalmology, Hanyang University Seoul Hospital, Wangsimni-ro 222, Seongdong-gu, Seoul, 04763, Korea.
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Liu J, De Francesco T, Schlenker M, Ahmed II. Icare Home Tonometer: A Review of Characteristics and Clinical Utility. Clin Ophthalmol 2020; 14:4031-4045. [PMID: 33262568 PMCID: PMC7695605 DOI: 10.2147/opth.s284844] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Accepted: 10/30/2020] [Indexed: 12/03/2022] Open
Abstract
The Icare HOME (TA022, Icare Oy, Vanda, Finland) is rebound tonometer recently approved by the US Food and Drug Administration in March 2017 designed for self-measurement of intraocular pressure (IOP). IOP remains a major modifiable risk factor for glaucoma progression; however, IOP measurements typically occur through single office measurements on Goldmann applanation tonometry (GAT) and do not always reveal the complete picture of patient’s IOP patterns and daily fluctuations, which are important for accurate diagnosis and evaluation. Numerous studies have now compared the efficacy of the Icare HOME to that of GAT. The objective of this article is to review the existing literature surrounding the Icare HOME tonometer and its efficacy as a self-tonometer in comparison to GAT. The available literature has shown promising results in its accuracy of measuring IOP but suggests cautious usage in patients with central corneal thicknesses or IOP ranges that are outside of a certain range. This article will also provide details and example cases for when the Icare HOME may be most clinically useful.
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Affiliation(s)
- John Liu
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada.,Prism Eye Institute, Oakville, Ontario, Canada
| | - Ticiana De Francesco
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada.,Prism Eye Institute, Oakville, Ontario, Canada
| | - Matthew Schlenker
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada.,Prism Eye Institute, Oakville, Ontario, Canada
| | - Iqbal Ike Ahmed
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada.,Prism Eye Institute, Oakville, Ontario, Canada
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Sanghi P, Malik M, Hossain IT, Manzouri B. Ocular Complications in the Prone Position in the Critical Care Setting: The COVID-19 Pandemic. J Intensive Care Med 2020; 36:361-372. [PMID: 32985317 DOI: 10.1177/0885066620959031] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
PURPOSE Ocular complications are common in the critical care setting but are frequently missed due to the focus on life-saving organ support. The SARS-CoV-2 (COVID-19) pandemic has led to a surge in critical care capacity and prone positioning practices which may increase the risk of ocular complications. This article aims to review all ocular complications associated with prone positioning, with a focus on challenges posed by COVID-19. MATERIALS AND METHODS A literature review using keywords of "intensive care", "critical care", "eye care", "ocular disorders", "ophthalmic complications," "coronavirus", "COVID-19," "prone" and "proning" was performed using the electronic databases of PUBMED, EMBASE and CINAHL. RESULTS The effects of prone positioning on improving respiratory outcomes in critically unwell patients are well established; however, there is a lack of literature regarding the effects of prone positioning on ocular complications in the critical care setting. Sight-threatening ophthalmic disorders potentiated by proning include ocular surface disease, acute angle closure, ischemic optic neuropathy, orbital compartment syndrome and vascular occlusions. CONCLUSIONS COVID-19 patients may be more susceptible to ocular complications with increased proning practices and increasing demand on critical care staff. This review outlines these ocular complications with a focus on preventative and treatment measures to avoid devastating visual outcomes for the patient.
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Affiliation(s)
- Priyanka Sanghi
- Department of Ophthalmology, Barking Havering and Redbridge University Hospitals NHS Trust, 156727Queens Hospital, Romford, UK
| | - Mohsan Malik
- Department of Ophthalmology, Barking Havering and Redbridge University Hospitals NHS Trust, 156727Queens Hospital, Romford, UK
| | - Ibtesham T Hossain
- Department of Ophthalmology, Barking Havering and Redbridge University Hospitals NHS Trust, 156727Queens Hospital, Romford, UK
| | - Bita Manzouri
- Department of Ophthalmology, Barking Havering and Redbridge University Hospitals NHS Trust, 156727Queens Hospital, Romford, UK
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Subramaniam AG, Allen P, Toh T. Comparison of the Icare ic100 Rebound Tonometer and the Goldmann Applanation Tonometer in 1,000 Eyes. Ophthalmic Res 2020; 64:321-326. [PMID: 32906125 DOI: 10.1159/000511455] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 09/08/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND Measurement of intraocular pressure (IOP) forms a crucial component in the diagnosis and management of glaucoma. Many devices have been developed to measure IOP with Goldmann applanation tonometry (GAT) considered the gold standard for IOP measurement. OBJECTIVES The objective was to compare the IOP measured using Icare ic100 and GAT. METHODS This cross-sectional study measured IOP in 1,000 eyes (500 left and 500 right) using the Icare ic100 and GAT. Central corneal thickness (CCT) was measured using a hand-held pachymeter. IOP measurements were investigated in all eyes, by IOP substrata, by CCT group, by number of topical glaucoma medications, and diagnosis. RESULTS There was moderate agreement between ic100 and GAT IOP measurements (intraclass correlation coefficient 0.73). Mean IOP was significantly lower when measured by ic100 than by GAT (12.1 vs. 16.2 mm Hg, p < 0.0001). Mean ic100 IOPs were also significantly lower than mean GAT IOPs within each IOP strata ≤12 (7.9 vs. 9.7 mm Hg, p < 0.0001), 13-21 (12.1 vs. 16.6 mm Hg, p < 0.0001), and ≥22 (18.4 vs. 25.2 mm Hg, p < 0.0001) and within each subanalysis. CONCLUSIONS The Icare tonometer consistently under estimated IOP compared to GAT, irrespective of CCT ranges and other subgroup analyses. The mean difference of 4.2 mm Hg can have significant clinical implications, particularly in the management of glaucoma patients.
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Affiliation(s)
- Arjun Gopal Subramaniam
- Tasmanian Eye Institute, Launceston, Tasmania, Australia.,Launceston Clinical School, College of Health and Medicine, University of Tasmania, Launceston General Hospital, Launceston, Tasmania, Australia
| | - Penelope Allen
- Tasmanian Eye Institute, Launceston, Tasmania, Australia, .,Rural Clinical School, College of Health and Medicine, University of Tasmania, Hospitals' Campus, Burnie, Tasmania, Australia,
| | - Tze'Yo Toh
- Tasmanian Eye Institute, Launceston, Tasmania, Australia
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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.
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Terao E, Nakakura S, Fujisawa Y, Nagata Y, Ueda K, Kobayashi Y, Oogi S, Dote S, Shiraishi M, Tabuchi H, Yoneda T, Fukushima A, Asaoka R, Kiuchi Y. Time course of conjunctival hyperemia induced by omidenepag isopropyl ophthalmic solution 0.002%: a pilot, comparative study versus ripasudil 0.4. BMJ Open Ophthalmol 2020; 5:e000538. [PMID: 32818152 PMCID: PMC7398095 DOI: 10.1136/bmjophth-2020-000538] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 06/19/2020] [Accepted: 06/28/2020] [Indexed: 11/24/2022] Open
Abstract
Objective We investigated the detailed time course of conjunctival hyperemia induced by omidenepag isopropyl ophthalmic solution 0.002% (omidenepag), a selective prostaglandin E2 receptor 2 agonist. Methods and analysis We recruited 34 healthy subjects and administered omidenepag in the right eye and ripasudil 0.4% in the left eye. We evaluated conjunctival hyperemia using slit-lamp photography at baseline and after 15, 30, 60, 120, 180 and 360 min. The conjunctival hyperemia score was graded by three independent observers using a scale from 0 (none) to 3 (severe). We also evaluated conjunctival hyperemia by the pixel coverage of conjunctival blood vessels (per cent coverage) determined using a conjunctival hyperemia-analysing software. Results In omidenepag, the conjunctival hyperemia score and per cent coverage peaked at both 30 min (mean score±SD: 1.57±0.67 and 11.90%±3.66%, respectively) and then gradually decreased at 60 min (10.79%±3.32%) and 120 min (1.10±0.52) when they reached a level that was not significantly different from the baseline values. For ripasudil 0.4%, the peak time of the conjunctival hyperemia score and per cent coverage were both at 15 min (score: 2.42±0.54 and 15.26%±3.38%). The degree of conjunctival hyperemia was significantly higher for ripasudil 0.4% than that for omidenepag from 15 to 30 min in both the conjunctival hyperemia score and per cent coverage (p<0.007 by Bonferroni correction). Conclusion Conjunctival hyperemia induced by omidenepag gradually peaks to moderate severity, though weaker compared with that induced by ripasudil 0.4%, and subsides relatively quickly.
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Affiliation(s)
- Etsuko Terao
- Department of Ophthalmology, Saneikai Tsukazaki Hospital, Himeji, Japan
| | - Shunsuke Nakakura
- Department of Ophthalmology, Saneikai Tsukazaki Hospital, Himeji, Japan
| | - Yasuko Fujisawa
- Department of Ophthalmology, Saneikai Tsukazaki Hospital, Himeji, Japan
| | - Yuki Nagata
- Department of Ophthalmology, Saneikai Tsukazaki Hospital, Himeji, Japan
| | - Kanae Ueda
- Department of Ophthalmology, Saneikai Tsukazaki Hospital, Himeji, Japan
| | - Yui Kobayashi
- Department of Ophthalmology, Saneikai Tsukazaki Hospital, Himeji, Japan
| | - Satomi Oogi
- Department of Ophthalmology, Saneikai Tsukazaki Hospital, Himeji, Japan
| | - Saki Dote
- Department of Ophthalmology, Saneikai Tsukazaki Hospital, Himeji, Japan
| | - Miku Shiraishi
- Department of Ophthalmology, Saneikai Tsukazaki Hospital, Himeji, Japan
| | - Hitoshi Tabuchi
- Department of Ophthalmology, Saneikai Tsukazaki Hospital, Himeji, Japan
| | - Tsuyoshi Yoneda
- Department of Sensory Science, Kawasaki University of Medical Welfare, Kurashiki, Japan
| | - Atsuki Fukushima
- Department of Ophthalmology, Kochi Medical School, Kochi University, Nankoku, Japan
| | - Ryo Asaoka
- Department of Ophthalmology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yoshiaki Kiuchi
- Department of Ophthalmology, Hiroshima University, Hiroshima, Japan
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Effect of Manual Upper Eyelid Elevation on Intraocular Pressure Measurement by Four Different Tonometers. Optom Vis Sci 2020; 97:128-133. [PMID: 32011586 DOI: 10.1097/opx.0000000000001472] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
SIGNIFICANCE This study is the first to show that the manual upper eyelid elevation (manual UEE) that is commonly used to prevent disruption of the IOP measurement due to blinking or upper eyelid contact with the tip of the tonometer does not affect the IOP values. PURPOSE We investigated whether manual UEE affects the IOP readings using three rebound tonometers (Icare TA01i, Icare PRO, and Icare ic100) and Goldmann applanation tonometry (GAT). METHODS One eye was measured for 101 patients (56 eyes of primary open-angle glaucoma patients and 45 healthy subjects). The IOPs were measured without and with manual UEE. Each IOP was measured twice; the measurement order using the tonometers was randomly selected. In addition, palpebral fissure height (distance between the upper and lower eyelids) was measured. RESULTS The IOPs without manual UEE were 12.1 ± 2.9, 13.3 ± 2.7, 11.7 ± 2.9, and 16.0 ± 3.2 mmHg (Icare TA01i, Icare PRO, Icare ic100, and GAT), and those with manual UEE were 12.3 ± 3.0, 13.3 ± 2.8, 11.7 ± 2.9, and 16.0 ± 3.3, respectively. No significant difference was found between the IOP without and with manual UEE (IOP difference; all, P > .50; paired t test). Multiple linear regression analyses revealed that palpebral fissure height did not affect IOP difference for any of the tonometers. CONCLUSIONS Simple manual UEE when measuring the IOP has little effect on the IOP obtained using all current rebound tonometers and GAT.
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Abstract
SIGNIFICANCE Icare HOME rebound tonometry is increasingly adopted into clinical practice for IOP phasing of glaucoma patients and suspects. Because of measurement differences with applanation tonometry and diurnal fluctuations, interpretation of the IOP measured with Icare HOME phasing can be challenging. PURPOSE The purpose of this study was to use a large patient cohort to develop a practical, analytical tool for interpreting Icare HOME measurements with respect to applanation pressure. METHODS IOP measurements using the Icare HOME and an applanation tonometer were taken prospectively in 498 consecutive patients. Bland-Altman, frequency distribution, and linear regression analysis were applied to determine measurement differences. A novel criterion, Threshold Icare HOME IOP, was developed to assist identification of elevation above target applanation pressure, considering the expected diurnal variation and measurement variability. RESULTS Icare HOME tended to underestimate applanation tonometry (mean bias, -1.7 mmHg; 95% limits of agreement, -7.0 to +3.6). Overall, differences were within ±3 mmHg in 71.5% and ±5 mmHg in 92% of patients. Based on the novel criterion developed, Icare HOME measurements that exceed target applanation pressure by 6 mmHg or greater are generally outside the 95% limit of expected observations. CONCLUSIONS The Threshold Icare HOME IOP is a novel and practical criterion that can assist clinicians in their interpretation of Icare HOME phasing measurements with respect to target applanation pressures. Elevation above the expected thresholds may prompt closer monitoring or even modifications to glaucoma management.
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Rebound Self-tonometry Acquisition Time and Ease of Use Evaluated by Newly Trained Optometry Students and Optometrists. Optom Vis Sci 2020; 97:94-100. [DOI: 10.1097/opx.0000000000001481] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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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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Otsuka M, Tojo N, Hayashi A. Error in measurement of intraocular pressure with the Icare and IcarePRO. Int Ophthalmol 2019; 40:439-445. [PMID: 31691898 DOI: 10.1007/s10792-019-01204-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Accepted: 10/22/2019] [Indexed: 11/29/2022]
Abstract
PURPOSE We sought to determine whether changes in the measurement angle of the Icare TA01i and IcarePRO tonometers led to errors in the measurement of intraocular pressure (IOP). METHODS In this prospective, single-facility study, we analyzed 77 patients from November 2017 to September 2019. We measured IOP with the Icare TA01i and IcarePRO while changing the angle of the device with the cornea center and analyzed the associated changes in the measurement. RESULTS IOP measured with the Icare tilted - 30°, - 15° vertically was significantly higher than that measured with the Icare tilted horizontally (p < 0.0001, p < 0.0001). The IOP measured with a + 10° vertical tilt was significantly lower than that measured horizontally (p < 0.0001). When the IcarePRO was tilted + 90° vertically, the IOP was significantly lower with the patient in the supine position than in the lateral position (p = 0.00058). CONCLUSIONS IOP measured with the Icare and IcarePRO is affected by the measurement angle. The study results will direct the clinicians to exercise extra precautions in determining the measurement angle while measuring IOP.
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Affiliation(s)
- Mitsuya Otsuka
- Department of Ophthalmology and Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, 2630 Sugitani, Toyama, 930-0194, Japan.
| | - Naoki Tojo
- Department of Ophthalmology and Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, 2630 Sugitani, Toyama, 930-0194, Japan
| | - Atsushi Hayashi
- Department of Ophthalmology and Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, 2630 Sugitani, Toyama, 930-0194, Japan
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Phan A, Truong P, Camp A, Stewart K, Suen B, Weinreb RN, Talke FE. A Wireless Handheld Pressure Measurement System for In Vivo Monitoring of Intraocular Pressure in Rabbits. IEEE Trans Biomed Eng 2019; 67:931-937. [PMID: 31247540 DOI: 10.1109/tbme.2019.2924440] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Intraocular pressure (IOP) is the leading modifiable risk factor for preventing vision loss in glaucoma patients. Direct and frequent IOP measurements are highly desirable to assess adequacy of treatment and prevent further vision loss. In this study, we report on successful in vivo measurements of intraocular pressure in rabbits using an optical IOP measurement system. The sensor was implanted during cataract surgery in two New Zealand white (NZW) rabbits and tested in vivo for ten weeks. Prior to implantation, the sensors were characterized in vitro in the physiologically relevant pressure range of 0-60 mmHg. A portable wireless handheld reader consisting of an internal beam splitter, a monochromatic light source, and a digital single-lens reflex (DSLR) camera was also designed and implemented to capture interference patterns from the sensor. The sensitivity and accuracy of the sensor was 30 nm/mmHg and ±0.2 mmHg, respectively. Ten weeks post-implantation, the two NZW rabbits continued to respond well to the implant with no observable inflammation, signs of infection, or biofouling. All IOP measurements were obtained using the portable DSLR handheld reader. Successful in vivo studies demonstrate biocompatibility of the IOP sensor and prove feasibility of the IOP measurement system. The system has the potential to be used in both clinical and patient point-of-care (home) settings to frequently and accurately measure pressure.
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Jędzierowska M, Koprowski R. Novel dynamic corneal response parameters in a practice use: a critical review. Biomed Eng Online 2019; 18:17. [PMID: 30760270 PMCID: PMC6375180 DOI: 10.1186/s12938-019-0636-3] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Accepted: 02/08/2019] [Indexed: 12/27/2022] Open
Abstract
Background Non-contact tonometers based on the method using air puff and Scheimpflug’s fast camera are one of the latest devices allowing the measurement of intraocular pressure and additional biomechanical parameters of the cornea. Biomechanical features significantly affect changes in intraocular pressure values, as well as their changes, may indicate the possibility of corneal ectasia. This work presents the latest and already known biomechanical parameters available in the new offered software. The authors focused on their practical application and the diagnostic credibility indicated in the literature. Discussion An overview of available literature indicates the importance of new dynamic corneal parameters. The latest parameters developed on the basis of biomechanics analysis of corneal deformation process, available in non-contact tonometers using Scheimpflug’s fast camera, are used in the evaluation of laser refractive surgery procedures, e.g. LASIK procedure. In addition, the assessment of changes in biomechanically corrected intraocular pressure confirms its independence from changes in the corneal biomechanics which may allow an intraocular pressure real assessment. The newly developed Corvis Biomechanical Index combined with the corneal tomography and topography assessment is an important aid in the classification of patients with keratoconus. Conclusion New parameters characterising corneal deformation, including Corvis Biomechanical Index and biomechanical compensated intraocular pressure, significantly extend the diagnostic capabilities of this device and may be helpful in assessing corneal diseases of the eye. Nevertheless, further research is needed to confirm their diagnostic pertinence.
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Affiliation(s)
- Magdalena Jędzierowska
- Department of Biomedical Computer Systems, Faculty of Computer Science and Materials Science, Institute of Computer Science, University of Silesia, ul. Będzińska 39, 41-200, Sosnowiec, Poland.
| | - Robert Koprowski
- Department of Biomedical Computer Systems, Faculty of Computer Science and Materials Science, Institute of Computer Science, University of Silesia, ul. Będzińska 39, 41-200, Sosnowiec, Poland
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Comparison of the Intraocular Pressure Measured Using the New Rebound Tonometer Icare ic100 and Icare TA01i or Goldmann Applanation Tonometer. J Glaucoma 2019; 28:172-177. [DOI: 10.1097/ijg.0000000000001138] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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