[动态轮廓眼压计的可重复性。与TonoPenXL眼压计和Goldmann压平眼压计的比较——一项对323只正常眼睛的临床研究]

[Reproducibility of dynamic contour tonometry. Comparison with TonoPenXL and Goldmann applanation tonometry - a clinical study on 323 normal eyes].

作者信息

Viestenz A, Langenbucher A, Viestenz A

机构信息

Augenklinik der Otto-von-Guericke-Universität, Magdeburg.

出版信息

Klin Monbl Augenheilkd. 2006 Oct;223(10):813-9. doi: 10.1055/s-2006-926862.

DOI:10.1055/s-2006-926862

PMID:17063423

Abstract

BACKGROUND

The PASCAL Dynamic Contour Tonometer (DCT) is a new diagnostic approach for the digital measurement of intraocular pressure (IOP) in eyes with glaucoma. The aim of this study was to evaluate the reproducibility of DCT in normal eyes and to compare DCT with Goldmann applanation tonometry (GAT) and TonoPenXL.

PATIENTS AND METHODS

A prospective cross-sectional study on 323 normal, consecutive eyes was performed. Eyes with an IOP of more than 23 mmHg (GAT) were excluded. Central corneal power (Zeiss Ophthalmometer) and central corneal thickness (ultrasound pachymetry: Tomey AL-1000) were taken. The IOP readings were obtained as follows: 3 x DCT [quality of measurement, IOP and ocular pulse amplitude (OPA) were taken], 1 x TonoPenXL, GAT, finally: once again DCT to evaluate the tonography effect.

RESULTS

The quality of 3 following IOP (DCT) readings was good (quality Q1 = 43.4 %, Q2 = 32.5 %, Q3 = 22.7 %). The reproducibility of the IOP (DCT) measurements was excellent (first measurement IOP (DCT) = 18.1 +/- 3.4 mmHg, second measurement IOP (DCT) = 18.1 +/- 3.4 mmHg, third measurement IOP (DCT) = 17.8 +/- 3.4 mmHg, Cronbach's alpha = 0.976). First and second IOP (DCT) values showed a strong correlation (r = 0.93). A significant tonography effect was observed between first and third IOP (DCT) measurements (0.4 mmHg; p = 0.004). Mean OPA (DCT) was 3.0 mmHg during the first three measurements (Cronbach's alpha = 0.964). IOP (DCT) and OPA (DCT) reproducibility showed no laterality. IOP (DCT) (17.7 +/- 3.4 mmHg) was significantly higher than IOP (TonoPenXL) (16.0 +/- 3.2 mmHg, n = 275; p < 0.001) and higher than IOP (GAT) (14.5 +/- 3.1 mmHg, n = 275; p < 0.001). The effect of tonography between the third and last IOP (DCT) measurement was zero (p = 0.6). IOP (DCT) and IOP (GAT) values were only weak correlated with central corneal thickness.

CONCLUSIONS

IOP and OPA values measured with the DCT are extraordinary reproducible in normal eyes. Frequently, DCT detects higher IOP values than those obtained with TonoPenXL and GAT. A reproducible measurement of IOP and OPA may open new diagnostic fields, e. g., in glaucoma detection or ocular vascular diseases.

摘要

背景

帕斯卡动态轮廓眼压计（DCT）是一种用于青光眼患者眼内压（IOP）数字测量的新诊断方法。本研究的目的是评估DCT在正常眼中的可重复性，并将DCT与戈德曼压平眼压计（GAT）和TonoPenXL进行比较。

患者与方法

对323只连续的正常眼进行了一项前瞻性横断面研究。排除IOP超过23 mmHg（GAT）的眼睛。测量中央角膜屈光力（蔡司角膜曲率计）和中央角膜厚度（超声测厚仪：多美AL-1000）。IOP读数的获取如下：3次DCT测量[记录测量质量、IOP和眼动脉搏动幅度（OPA）]，1次TonoPenXL测量，GAT测量，最后：再次进行DCT测量以评估眼压描记效应。

结果

随后3次IOP（DCT）读数的质量良好（质量Q1 = 43.4%，Q2 = 32.5%，Q3 = 22.7%）。IOP（DCT）测量的可重复性极佳（首次测量IOP（DCT）= 18.1±3.4 mmHg，第二次测量IOP（DCT）= 18.1±3.4 mmHg，第三次测量IOP（DCT）= 17.8±3.4 mmHg，克朗巴哈系数α = 0.976）。第一次和第二次IOP（DCT）值显示出很强的相关性（r = 0.93）。在第一次和第三次IOP（DCT）测量之间观察到显著的眼压描记效应（0.4 mmHg；p = 0.004）。前三次测量期间的平均OPA（DCT）为3.0 mmHg（克朗巴哈系数α = 0.964）。IOP（DCT）和OPA（DCT）的可重复性无左右差异。IOP（DCT）（17.7±3.4 mmHg）显著高于IOP（TonoPenXL）（16.0±3.2 mmHg，n = 275；p < 0.001），也高于IOP（GAT）（14.5±3.1 mmHg，n = 275；p < 0.001）。第三次和最后一次IOP（DCT）测量之间的眼压描记效应为零（p = 0.6）。IOP（DCT）和IOP（GAT）值与中央角膜厚度仅呈弱相关。