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. 2015 Jan-Mar;10(1):43-8.
doi: 10.4103/2008-322X.156105.

Intraocular pressure measurement by three different tonometers in primary congenital glaucoma

Athar Zareei  1 , Mohammad Reza Razeghinejad  2 , Mohammad Hosein Nowroozzadeh  2 , Yadollah Mehrabi  3 , Mohammad Aghazadeh-Amiri  3
Affiliations

Intraocular pressure measurement by three different tonometers in primary congenital glaucoma

Athar Zareei et al. J Ophthalmic Vis Res. 2015 Jan-Mar.

Abstract

Purpose: To determine the agreement between intraocular pressure (IOP) measurements using an automated non-contact tonometer (NCT), Goldmann applanation tonometer (GAT), and the ocular response analyzer (ORA) in subjects with primary congenital glaucoma (PCG).

Methods: Twenty-nine eyes of 17 PCG patients underwent IOP measurements using NCT, GAT and ORA. Variables obtained by the ORA were corneal-compensated IOP (IOPcc), Goldmann-correlated IOP (IOPg), corneal hysteresis (CH), and corneal resistance factor (CRF). A difference more than 1.5 mmHg for IOP was considered as clinically relevant.

Results: Mean age of the patients was 12 years. Mean IOP (±standard deviation, SD) was 15.3 ± 2.8 mmHg (GAT), 15.5 ± 6.0 (NCT), 19.2 ± 7.0 (IOPg), and 21.1 ± 7.9 (IOPcc); (P = 0.001). Except for NCT vs. GAT (P = 1.0), the average IOP difference between each pair of measurements was clinically relevant. The 95% limits of agreements were - 10.2 to 10.3 mmHg (NCT vs. GAT), -7.8 to 15.3 (IOPg vs. GAT), and - 8.1 to 19.0 (IOPcc vs. GAT). The differences in IOP measurements increased significantly with higher average IOP values (r = 0.715, P = 0.001, for NCT vs. GAT; r = 0.802, P < 0.001, for IOPg vs. GAT; and r = 0.806, P < 0.001, for IOPcc vs. GAT). CH showed a significant association with differences in IOP measurements only for IOPcc vs. GAT (r = 0.830, P < 0.001).

Conclusion: Mean IOP obtained by NCT was not significantly different from that of GAT, but ORA measured IOPs were significantly higher than both other devices.

Keywords: Goldmann Applanation Tonometer; Intraocular Pressure; Noncontact Tonometer; Ocular Response Analyzer; Primary Congenital Glaucoma.

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Conflict of interest statement

Conflict of Interest: None declared.

Figures

Figure 1
Figure 1
Box and whisker plot showing the distribution of intraocular pressure (IOP) measurements by non-contact tonometer (NCT), Goldmann applanation tonometer (GAT), Goldmann-correlated IOP (IOPg), and corneal compensated IOP (IOPcc).
Figure 2
Figure 2
Bland-Altman plots for different measurements compared with Goldmann applanation tonometer. The differences between the two methods are plotted against the mean value of both. The upper and lower lines represent the 95% limits of agreement. Non-contact tonometer (NCT), Goldmann applanation tonometer (GAT), Goldmann correlated IOP (IOPg), corneal compensated IOP (IOPcc).
Figure 3
Figure 3
Bland-Altman plots with subgroup analysis. The eyes with an average intraocular pressure (IOP) of >15.8 mmHg are compared to those with an average IOP of <15.8 mmHg. The differences between the two devices are plotted against the mean value of both for each subgroup. The upper and lower lines represent the 95% limits of agreement. Non-contact tonometer (NCT), Goldmann applanation tonometer (GAT), Goldmann-correlated IOP (IOPg), corneal compensated IOP (IOPcc).
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