Division of Eye and Vision, Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden.
Department of Anterior Segment Disorders, Glaucoma, Neuro-Ophthalmology and Oculoplastics, St. Erik Eye Hospital, Solna, Sweden.
Acta Ophthalmol. 2023 Mar;101(2):e246-e251. doi: 10.1111/aos.15256. Epub 2022 Sep 22.
The aim of this study was to examine the impact of self-tonometry on clinicians' decision in glaucoma treatment.
Medical records of 133 patients who had performed self-tonometry using iCare Home between January and December 2019 were retrospectively reviewed. Inclusion criteria were as follows: age over 18 years, all types of glaucoma, as well as ocular hypertension and glaucoma suspect, compliance with tonometer manufacturer's recommendations and monitoring over at least 2 days. The data consisted of age, gender, diagnosis, visual field index, rate of progression and type of treatment pre- and post-intraocular pressure (IOP) phasing. The following IOP measurements were used to calculate the mean and maximum IOP, and range over each day and consecutive days: Goldmann applanation tonometry (GAT) measurements from referral and training visits and iCare Home measurements made by the trainers and the patients themselves. A total of 90 patients were included.
Clinicians were satisfied with the actual treatment in 54.4% of the cases. There was a statistically significant difference between the clinicians' decision to maintain same treatment or to escalate therapy for all the mean and maximum IOPs measured on each single day and over a 2- or 3-day period (p < 0.002).
Our results suggest that the presence of high IOP values obtained with self-tonometry supports an intensification of glaucoma treatment. Self-tonometry provides clinicians with an important complement for clinical decision-making, and under- or over-treatment may be avoided for the benefit of patients.
本研究旨在探讨眼压自测量对青光眼治疗决策的影响。
回顾性分析了 2019 年 1 月至 12 月期间使用 iCare Home 进行眼压自测量的 133 名患者的病历。纳入标准为：年龄超过 18 岁，所有类型的青光眼，以及高眼压症和青光眼疑似患者，符合眼压计制造商的建议并进行至少 2 天的监测。数据包括年龄、性别、诊断、视野指数、进展率和治疗前和治疗后眼压（IOP）分期的类型。以下眼压测量用于计算平均眼压和最大眼压以及每天和连续几天的眼压范围：转诊和培训访问时的 Goldmann 压平眼压计（GAT）测量值以及培训师和患者自己进行的 iCare Home 测量值。共纳入 90 名患者。
在 54.4%的情况下，临床医生对实际治疗感到满意。在所有单日内和 2 至 3 天内测量的平均眼压和最大眼压方面，临床医生维持相同治疗或升级治疗的决策存在统计学差异（p<0.002）。
我们的结果表明，眼压自测量值高支持加强青光眼治疗。眼压自测量为临床医生的决策提供了重要的补充，避免了治疗不足或过度，有利于患者。
