Shin Jonghoon, Lee Ji-Woong, Kim Eun-Ah, Caprioli Joseph
Department of Ophthalmology, Pusan National University Hospital, Busan, South Korea.
Department of Ophthalmology, Pusan National University Hospital, Busan, South Korea; Medical Research Institute, Pusan National University Hospital, Busan, South Korea; The Jules Stein Eye Institute, University of California at Los Angeles School of Medicine, Los Angeles, California.
Am J Ophthalmol. 2015 Jan;159(1):144-54. doi: 10.1016/j.ajo.2014.10.007. Epub 2014 Oct 13.
To evaluate the effects of corneal biomechanical properties on intraocular pressure (IOP) measured with the ICare, and to compare IOP readings obtained with ICare, Ocular Response Analyzer (ORA), and Goldmann applanation tonometry (GAT) in normal-tension glaucoma (NTG) and normal subjects.
Prospective, cross-sectional, comparative study.
IOP was measured with ICare, ORA, and GAT. All subjects had corneal hysteresis (CH) and corneal resistance factor (CRF), which were measured with ORA; and central corneal thickness (CCT), axial length, spherical equivalent, and keratometry.
This study enrolled 97 eyes of 97 NTG patients and 89 eyes of 89 normal subjects. CCT, CH, and CRF in NTG patients were significantly lower than those in normal subjects (P = .033, P = .006, and P = .003). The difference in IOP between techniques was highly significant in NTG patients (P < .001), while there was no significant difference in IOP values between techniques in normal controls (P = .931). ICare readings were significantly lower than corneal-compensated IOP in NTG patients (P = .014). CH and CRF were significantly associated with IOP measurements with ICare in NTG and normal subjects (P < .001). The greater difference between IOPcc and ICare in NTG patients was significantly influenced by the lower CH (P < .001).
Since ICare is a convenient way to measure IOP, ICare is a reasonable option as an alternative tonometer in NTG patients. However, the clinician must consider that the corneal biomechanical characteristics in NTG can cause ICare to underestimate IOP.
评估角膜生物力学特性对使用Icare测量眼压（IOP）的影响，并比较正常眼压性青光眼（NTG）患者和正常受试者使用Icare、眼反应分析仪（ORA）和Goldmann压平眼压计（GAT）所测得的眼压读数。
前瞻性、横断面、对比研究。
使用Icare、ORA和GAT测量眼压。所有受试者均测量了角膜滞后量（CH）和角膜阻力因子（CRF）（使用ORA测量）；以及中央角膜厚度（CCT）、眼轴长度、等效球镜度和角膜曲率。
本研究纳入了97例NTG患者的97只眼和89例正常受试者的89只眼。NTG患者的CCT、CH和CRF显著低于正常受试者（P = 0.033、P = 0.006和P = 0.003）。NTG患者中不同测量技术之间的眼压差异具有高度显著性（P < 0.001），而正常对照组中不同技术测得的眼压值无显著差异（P = 0.931）。NTG患者中Icare读数显著低于角膜补偿眼压（P = 0.014）。NTG患者和正常受试者中，CH和CRF与使用Icare测量的眼压显著相关（P < 0.001）。NTG患者中眼压补偿值（IOPcc）与Icare之间的较大差异受较低的CH显著影响（P < 0.001）。
由于Icare是一种便捷的眼压测量方法，因此在NTG患者中作为替代眼压计是一个合理的选择。然而，临床医生必须考虑到NTG患者的角膜生物力学特性可能导致Icare低估眼压。
