Velis Girish, Kavitha Srinivasan, Zebardast Nazlee, Sengupta Sabyasachi, Venkatesh Rengaraj
Department of Glaucoma, Aravind Eye Hospital, Pondicherry, India.
Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA.
Indian J Ophthalmol. 2020 Apr;68(4):620-626. doi: 10.4103/ijo.IJO_570_19.
To compare corrected intraocular pressure (IOP) by tonopachy with that of Goldmann applanation tonometry (GAT) in normal and glaucomatous patients.
In this cross-sectional study, IOP and central corneal thickness (CCT) were measured in 426 eyes (213 normal eyes and 213 glaucomatous eyes) of 426 patients by tonopachy followed by GAT and ultrasound pachymetry. IOP was corrected for CCT by in-built formula in tonopachy and Ehlers correction factor for Goldmann tonometer. Limits of agreements were assessed using Bland-Altman plots. Intraclass correlation coefficient was calculated to estimate the absolute agreement between single and average measurements of IOP and CCT of tonopachy with that of Goldmann tonometer and ultrasound pachymetry respectively.
Mean corrected IOP measured with tonopachy and GAT in glaucomatous eyes was 17.63 ± 5.04 mmHg and 19.42 ± 5.83 mmHg, and in controls it was 13.4 ± 2.5 mmHg and 16.2 ± 3.1 mmHg, respectively. Limits of agreement ranged from -4.63 to +9.25 mmHg for total population (mean = 2.31), -6.01 to +9.59 mmHg (mean = 1.79) for glaucoma group and -2.99 to +8.65 mmHg (mean = 2.83) for controls. Intraclass correlation coefficient for IOP measurement between tonopachy and Goldmann tonometer was 0.84 for total population, 0.85 for glaucoma group, and 0.63 for controls, respectively.
Corrected IOP obtained by tonopachy showed moderate agreement with GAT and it is more in glaucoma patients than controls. Thus, tonopachy can be used as a screening tool, but cannot replace GAT.
比较正常人和青光眼患者使用眼压笔测量的校正眼压(IOP)与Goldmann压平眼压计(GAT)测量的眼压。
在这项横断面研究中,对426例患者的426只眼(213只正常眼和213只青光眼眼)先使用眼压笔测量眼压和中央角膜厚度(CCT),随后使用GAT和超声测厚仪进行测量。眼压笔通过内置公式校正CCT,Goldmann眼压计使用Ehlers校正因子。使用Bland-Altman图评估一致性界限。计算组内相关系数,以分别估计眼压笔单次测量和平均测量的IOP及CCT与Goldmann眼压计和超声测厚仪测量结果之间的绝对一致性。
青光眼眼中,眼压笔和GAT测量的平均校正眼压分别为17.63±5.04 mmHg和19.42±5.83 mmHg;对照组中,分别为13.4±2.5 mmHg和16.2±3.1 mmHg。总体人群的一致性界限为-4.63至+9.25 mmHg(均值=2.31),青光眼组为-6.01至+9.59 mmHg(均值=1.79),对照组为-2.99至+8.65 mmHg(均值=2.83)。眼压笔与Goldmann眼压计测量IOP的组内相关系数,总体人群为0.84,青光眼组为0.85,对照组为0.63。
眼压笔获得的校正眼压与GAT显示出中等程度的一致性,在青光眼患者中比对照组更高。因此,眼压笔可作为一种筛查工具,但不能替代GAT。