Yashio Maruyama Eye Clinic, Saitama, Japan.
J Glaucoma. 2024 Mar 1;33(3):183-188. doi: 10.1097/IJG.0000000000002312. Epub 2023 Sep 12.
Use of the Ocular Response Analyzer (ORA) as a screening tonometer in clinical practice yielded reliable measurements in over 80% of eyes screened. Including corneal hysteresis (CH) data in screening may improve the accuracy of glaucoma detection.
To examine measurement reliability when the ORA is used as a screening tonometer, and to compare CH measurements in eyes with and those without glaucomatous changes in the fundus.
1488 eyes of 747 patients (mean age: 53.5 ± 20.4 y, range: 6-94 y) underwent intraocular pressure (IOP) measurement using ORA as screening. The percentage of eyes with a waveform score ≥6, the recommended threshold indicating reliability, was calculated. Eyes that had waveform score ≥6 and had undergone fundus photography and optical coherence tomography were assessed for the presence or absence of glaucomatous changes in fundus from optical coherence tomography and fundus images, and CH was compared between the 2 groups.
Mean ± SD (range) of ORA measurements were: Goldmann-correlated IOP 14.9 ± 4.8 (1.0-63.2) mm Hg, corneal-compensated IOP 16.2 ± 4.7 (3.2-73.6) mm Hg, CH 9.7 ± 1.5 (0.0-20.6) mm Hg, and waveform score 7.3 ± 1.5 (0.1-9.7). Eighty-four percent of eyes had a waveform score ≥6. Among 192 eyes (127 patients, aged 53.5 ± 18.0 y) with waveform score ≥6 and evaluable for glaucomatous changes in the fundus, 53 eyes were determined as positive and 139 eyes as negative. CH was 9.6 ± 1.4 (6.8-13.3) mm Hg in the positive group and 10.2 ± 1.2 (6.9-13.3) mm Hg in the negative group, and was significantly lower in the positive group ( P =0.003).
When using ORA as a screening tonometer, reliable results were obtained in ~80% of the eyes. CH was lower in the glaucomatous change-positive group compared with the glaucomatous change-negative group, but the ranges overlapped between the 2 groups.
在临床实践中，使用眼部反应分析仪（ORA）作为筛查眼压计，超过 80%的受检眼可获得可靠的测量结果。在筛查中纳入角膜滞后（CH）数据可能会提高青光眼检测的准确性。
检查 ORA 作为筛查眼压计时的测量可靠性，并比较眼底有和无青光眼改变的眼睛的 CH 测量值。
1488 只眼（747 例患者，平均年龄 53.5±20.4 岁，范围 6-94 岁）接受了 ORA 作为筛查的眼压测量。计算了波形评分≥6（表示可靠性的推荐阈值）的眼的百分比。对那些波形评分≥6 且已经接受了眼底照相和光学相干断层扫描的眼，评估光学相干断层扫描和眼底图像中的眼底是否存在青光眼改变，并比较两组之间的 CH。
ORA 测量的平均值±标准差（范围）为：Goldmann 相关眼压 14.9±4.8（1.0-63.2）mmHg，角膜补偿眼压 16.2±4.7（3.2-73.6）mmHg，CH 9.7±1.5（0.0-20.6）mmHg，波形评分 7.3±1.5（0.1-9.7）。84%的眼的波形评分≥6。在 192 只眼（127 例患者，年龄 53.5±18.0 岁）中，这些眼的波形评分≥6，且可评估眼底的青光眼改变，53 只眼为阳性，139 只眼为阴性。阳性组的 CH 为 9.6±1.4（6.8-13.3）mmHg，阴性组为 10.2±1.2（6.9-13.3）mmHg，阳性组明显较低（P=0.003）。
当使用 ORA 作为筛查眼压计时，约 80%的眼可获得可靠的结果。与青光眼改变阴性组相比，青光眼改变阳性组的 CH 较低，但两组之间的范围重叠。
