Pronin Savva, Brown Lyndsay, Megaw Roly, Tatham Andrew J
Princess Alexandra Eye Pavilion, Department of Ophthalmology, University of Edinburgh, Edinburgh, Scotland.
JAMA Ophthalmol. 2017 Oct 1;135(10):1030-1036. doi: 10.1001/jamaophthalmol.2017.3151.
The ability of patients to measure their own intraocular pressure (IOP) would allow more frequent measurements and better appreciation of peak IOP and IOP fluctuation.
To examine whether patients with glaucoma can perform self-tonometry using a rebound tonometer and examine patient acceptability.
DESIGN, SETTING, AND PARTICIPANTS: An observational study in which IOP was assessed using Goldmann applanation tonometry and a rebound tonometer. Consecutive patients were provided with a patient information sheet and those consenting to take part in the study received standardized self-tonometry training and were then instructed to measure their own IOP under observation. This study was conducted at a glaucoma clinic at a university hospital from March 1, 2016, to December 30, 2016, and included both eyes of 100 patients with glaucoma or ocular hypertension.
The percentage of patients who could successfully perform self-tonometry. Complete success was defined by a good technique and an IOP reading within 5 mm Hg of that obtained by a clinician using the same device. A 3-item questionnaire was used to examine perceptions of self-tonometry among patients.
Among the 100 patients, the mean (SD) age was 67.5 (10.9) years (53% female). A total 73 of 100 patients (73%) met the complete success criteria. An additional 6 patients could use the device but had IOP readings greater than 5 mm Hg different from those obtained by the clinician. On average, IOP by the rebound tonometer was 2.66 mm Hg lower than Goldmann applanation tonometry (95% limits of agreement, -3.48 to 8.80 mm Hg). The IOPs with the rebound tonometer were similar whether obtained by self-tonometry or investigator, with excellent reproducibility with an intraclass correlation coefficient of 0.903 (95% CI, 0.867-0.928). A total of 56 of 79 successful or partially successful patients (71%) felt self-tonometry was easy, with 73 of 79 (92%) reporting self-tonometry to be comfortable, and a similar number happy to perform self-tonometry in the future.
Most patients could perform self-tonometry and the method was acceptable to patients. Self-tonometry has the potential to improve patient engagement, while also providing a more complete picture of IOP changes over time.
患者自行测量眼压（IOP）的能力将有助于更频繁地进行测量，并更好地了解眼压峰值和眼压波动情况。
研究青光眼患者是否能够使用回弹式眼压计进行自我眼压测量，并评估患者的接受程度。
设计、地点和参与者：一项观察性研究，使用Goldmann压平眼压计和回弹式眼压计评估眼压。为连续就诊的患者提供患者信息表，同意参与研究的患者接受标准化的自我眼压测量培训，然后在观察下自行测量眼压。本研究于2016年3月1日至2016年12月30日在一家大学医院的青光眼诊所进行，纳入了100例青光眼或高眼压症患者的双眼。
能够成功进行自我眼压测量的患者百分比。完全成功的定义为技术良好且眼压读数与临床医生使用同一设备测得的读数相差在5 mmHg以内。使用一份包含3个条目的问卷来调查患者对自我眼压测量的看法。
100例患者中，平均（标准差）年龄为67.5（10.9）岁（女性占53%）。100例患者中有73例（73%）达到完全成功标准。另外6例患者能够使用该设备，但眼压读数与临床医生测得的读数相差超过5 mmHg。平均而言，回弹式眼压计测得的眼压比Goldmann压平眼压计低2.66 mmHg（95%一致性界限为-3.48至8.80 mmHg）。无论由患者自行测量还是由研究人员测量，回弹式眼压计测得的眼压相似，组内相关系数为0.903（95%CI，0.867 - 0.928），具有出色的重复性。79例成功或部分成功的患者中，共有56例（71%）认为自我眼压测量很容易，79例中有73例（92%）表示自我眼压测量很舒适，且有相近数量的患者愿意在未来进行自我眼压测量。
大多数患者能够进行自我眼压测量，且该方法为患者所接受。自我眼压测量有可能提高患者的参与度，同时也能更全面地呈现眼压随时间的变化情况。
