Nakao Yoshitaka, Kiuchi Yoshiaki, Okimoto Satoshi
Ophthalmology and Visual Science Department, Hiroshima University, Hiroshima, Japan.
PLoS One. 2017 Jan 17;12(1):e0170206. doi: 10.1371/journal.pone.0170206. eCollection 2017.
The purpose of the study was to investigate the accuracy of two corrected intraocular pressure (IOP) measurements by Corvis Scheimpflug Technology (CST)-IOPpachy and by corneal-compensated IOP (IOPcc) using the Reichert 7CR (7CR) tonometers. We also investigated the effects of corneal anatomical and structural parameters on the IOP measurements. The participants included 90 primary open-angle glaucoma patients. We assessed the IOP measurements, obtained by the CST, 7CR, and Goldmann applanation tonometer (GAT), using a paired t-test with Bonferroni correction, Bland-Altman plots, and multiple regression analyses. The 7CR-IOPcc gave the highest value (15.5 ± 2.7 mmHg), followed by the 7CR-IOPg (13.7 ± 3.1 mmHg), GAT-IOP (13.6 ± 2.2 mmHg), CST-IOP (10.3 ± 2.6 mmHg), and CST-IOPpachy (9.7 ± 2.5 mmHg). The values of CST-IOPpachy were significantly lower than those obtained by the other IOP measurement methods (all, p < 0.01). The values of 7CR-IOPcc were significantly higher than those obtained by the other IOP measurement methods (all, p < 0.01). Bland-Altman plots showed a mean difference between the GAT-IOP and the other IOP measurements (CST-IOP, CST-IOPpachy, 7CR-IOPg, and 7CR-IOPcc), which were -3.20, -3.82, 0.14, and 2.00 mmHg, respectively. The widths of the 95% limits of agreement between all pairs of IOP measurements were greater than 3 mmHg. With the exception of the 7CR-IOPcc, all of the IOP variations were explained by regression coefficients involving gender, average corneal curvature, and central corneal thickness. The IOP values obtained by the GAT, CST, and 7CR were not interchangeable. Each new IOP measurement device that was corrected for ocular structure had its own limitations.
本研究的目的是使用Reichert 7CR眼压计,通过Corvis Scheimpflug技术(CST)测量的校正眼压(IOP)——CST眼压-角膜厚度测量值(IOPpachy)以及角膜补偿眼压(IOPcc),来调查两种校正眼压测量方法的准确性。我们还研究了角膜解剖和结构参数对眼压测量的影响。研究对象包括90例原发性开角型青光眼患者。我们使用经Bonferroni校正的配对t检验、Bland-Altman图和多元回归分析,评估了通过CST、7CR和Goldmann压平眼压计(GAT)获得的眼压测量值。7CR-IOPcc给出的值最高(15.5±2.7 mmHg),其次是7CR-IOPg(13.7±3.1 mmHg)、GAT-IOP(13.6±2.2 mmHg)、CST-IOP(10.3±2.6 mmHg)和CST-IOPpachy(9.7±2.5 mmHg)。CST-IOPpachy的值显著低于通过其他眼压测量方法获得的值(均为p<0.01)。7CR-IOPcc的值显著高于通过其他眼压测量方法获得的值(均为p<0.01)。Bland-Altman图显示GAT-IOP与其他眼压测量值(CST-IOP、CST-IOPpachy、7CR-IOPg和7CR-IOPcc)之间的平均差异,分别为-3.20、-3.82、0.14和2.00 mmHg。所有眼压测量值对之间95%一致性界限的宽度均大于3 mmHg。除了7CR-IOPcc外,所有眼压变化均由涉及性别、平均角膜曲率和中央角膜厚度的回归系数解释。通过GAT(Goldmann压平眼压计)、CST(Corvis Scheimpflug技术)和7CR(Reichert 7CR眼压计)获得的眼压值不可互换。每种针对眼部结构进行校正的新型眼压测量设备都有其自身的局限性。