Weng Jenchieh, Tsai I-Lun, Kuo Li-Lin, Tsai Ching-Yao, Woung Lin-Chung, Hsiao Ya-Chuan
Department of Ophthalmology, Taipei City Hospital, Taipei, Taiwan.
Community Medicine Research Center, Institute of Public Health, National Yang-Ming University, Taipei, Taiwan.
Taiwan J Ophthalmol. 2017 Jul-Sep;7(3):149-154. doi: 10.4103/tjo.tjo_45_17.
BACKGROUND/PURPOSE: Topical atropine treatment is generally accepted to retard the progression of myopia, but it is associated with side effects such as photophobia and elevation of intraocular pressure (IOP). IOP measurements in children are challenging. The traditional applanation tonometry by direct contact with the cornea will require patient's cooperation. The rebound tonometer, using a dynamic electromechanical method for measuring IOP, shows good correlation with traditional tonometry. The purpose of this study is to evaluate the IOP of myopic children under atropine treatment using rebound tonometer and to compare the characteristics between rebound tonometry and applanation tonometry.
This study is a prospective study measuring IOP by rebound tonometer in myopic children under regular low-dose atropine treatment. We recruited children with refraction error showing myopia over -0.5 D with 0.15%, 0.3%, or 0.5% atropine eye drops use every night or every other night for myopia control. Children with treatment duration of atropine <1 month were excluded from the study. IOP measurements were performed by applanation tonometer (Tono-Pen XL, Reichert) and rebound tonometer (ICARE). The reliability of rebound tonometer was analyzed with percentage. Comparison of IOP between rebound tonometer and applanation tonometry was presented.
The rebound tonometry was well tolerated by all participants and caused no complaints, discomfort, or adverse events. Totally 42 myopic eyes of 42 subjects were included in the study. The average age of these participants was 10 years old, range from 5 to 16. Median = 10 years old. The average IOP of the right eye by rebound tonometer was 17.4 ± 3 mmHg, and 17.1 ± 3 mmHg by applanation tonometry. Nearly 19%, 33%, and 24% of difference of IOP readings between rebound tonometer and Tono-Pen applanation are within 0 mmHg, 1 mmHg, and 1-2 mmHg, respectively.
Rebound tonometry has good correlation with applanation tonometry and 76.1% of differences between two tonometers are <2 mmHg. The advantage of drop-free rebound tonometry has made it easier to obtain IOP readings in myopia children under atropine treatment.
背景/目的：局部使用阿托品治疗通常被认为可延缓近视进展，但它会带来畏光和眼压（IOP）升高等副作用。儿童眼压测量具有挑战性。传统的通过直接接触角膜的压平眼压计测量需要患者配合。回弹眼压计采用动态机电方法测量眼压，与传统眼压计显示出良好的相关性。本研究的目的是使用回弹眼压计评估阿托品治疗下近视儿童的眼压，并比较回弹眼压计和压平眼压计的特点。
本研究是一项前瞻性研究，通过回弹眼压计测量接受常规低剂量阿托品治疗的近视儿童的眼压。我们招募了屈光不正显示近视超过-0.5D的儿童，每晚或每隔一晚使用0.15%、0.3%或0.5%阿托品滴眼液控制近视。阿托品治疗持续时间<1个月的儿童被排除在研究之外。眼压测量通过压平眼压计（Tono-Pen XL，Reichert）和回弹眼压计（ICARE）进行。用百分比分析回弹眼压计的可靠性。呈现回弹眼压计和压平眼压计之间眼压的比较。
所有参与者对回弹眼压计耐受性良好，未引起任何抱怨、不适或不良事件。本研究共纳入42名受试者的42只近视眼睛。这些参与者的平均年龄为10岁，范围为5至16岁。中位数=10岁。回弹眼压计测量右眼的平均眼压为17.4±3mmHg，压平眼压计测量为17.1±3mmHg。回弹眼压计和Tono-Pen压平眼压计之间眼压读数差异分别有近19%、33%和24%在0mmHg、1mmHg和1-2mmHg范围内。
回弹眼压计与压平眼压计具有良好的相关性，两种眼压计之间76.1%的差异<2mmHg。免滴药的回弹眼压计的优势使得在接受阿托品治疗的近视儿童中更容易获得眼压读数。
