Kawai Motofumi, Kawai Naoko, Nakabayashi Seigo, Kinouchi Reiko, Yoshida Akitoshi
Department of Ophthalmology, Asahikawa Medical University, Midorigaokahigashi 2-1-1-1, Asahikawa, 078-8510, Japan.
Int Ophthalmol. 2017 Feb;37(1):95-101. doi: 10.1007/s10792-016-0217-4. Epub 2016 Apr 12.
To compare the intraocular pressure (IOP) variability measured by multiple clinicians with those by one clinician. Forty-seven of 227 consecutive patients with glaucoma who had been examined routinely for over 12 months without changes in antiglaucoma medications at Asahikawa Medical University were included. Patients were assigned to one of two groups based on whether they had been followed by multiple or one clinician. One eye of each patient was evaluated. The IOPs obtained using Goldmann applanation tonometry were evaluated. We used the IOP standard deviation (SD, mmHg) and coefficient of variation (CV, %) as parameters of IOP variability. The main outcome measures were the differences in SD and CV between the groups. Multiple linear regression analysis evaluated factors associated with the SD and CV. Twenty-four (51.1 %) patients were assigned to the multiple-clinicians group and 23 (48.9 %) to the single-clinician group. The mean ± SD and CV were higher in the former (1.9 ± 0.5 and 12.0 ± 3.7, respectively) than in the latter group (1.4 ± 0.3 and 10.1 ± 2.5; P = 0.0005 and 0.044, respectively). The number of treating clinicians was the factor most associated with the SD and CV (β = 0.455, P = 0.002 and β = 0.387, P = 0.008, respectively). The variability in the IOP measurements of patients who had been monitored by multiple clinicians was higher than in patients followed by one clinician. The factor most associated with IOP variability was the number of clinicians involved.
比较多名临床医生与一名临床医生测量的眼压（IOP）变异性。旭川医科大学连续227例青光眼患者中，有47例在12个月以上的时间里接受了常规检查，且抗青光眼药物未发生变化，这些患者被纳入研究。根据患者是由多名临床医生还是一名临床医生随访，将其分为两组。对每位患者的一只眼睛进行评估。评估使用Goldmann压平眼压计获得的眼压。我们将眼压标准差（SD，mmHg）和变异系数（CV，%）作为眼压变异性的参数。主要结局指标是两组之间SD和CV的差异。多元线性回归分析评估与SD和CV相关的因素。24例（51.1%）患者被分配到多名临床医生组，23例（48.9%）被分配到单名临床医生组。前者的平均±SD和CV更高（分别为1.9±0.5和12.0±3.7），高于后者组（1.4±0.3和10.1±2.5；P分别为0.0005和0.044）。治疗临床医生的数量是与SD和CV最相关的因素（β分别为0.455，P = 0.002和β为0.387，P = 0.008）。由多名临床医生监测的患者眼压测量的变异性高于由一名临床医生随访的患者。与眼压变异性最相关的因素是参与的临床医生数量。
