Ocular Response Analyzer versus Goldmann Applanation Tonometer for Measurement of Intra-Ocular Pressure

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Rim Raafat Fayez ◽  
Mohamed Adel Abdelshafik ◽  
Ahmed Ibrahim Aboulenain ◽  
Momen Mahmoud Hamdi
Keyword(s):  
Corneal Thickness ◽  
Cross Sectional Study ◽  
Applanation Tonometry ◽  
Ocular Response Analyzer ◽  
Cross Sectional ◽  
Goldmann Applanation Tonometer ◽  
Applanation Tonometer ◽  
Iop Measurement ◽  
The Mean ◽  
Method Of Evaluation

Abstract Background Goldmann applanation tonometry (GAT) has been the gold standard for intraocular pressure(IOP) measurement ,since its appearance in clinical practice around 50 years ago.(1) In spite of being almost unchallenged, the last few years have become a sustained search for a new standard method for IOP measurement,. One such recently marketed instrument is the Ocular Response Analyzer (ORA), which able to detect the corneal biomechanics. Aim of the Work is to compare the IOP measurement estimated by Goldmann applanation tonometer to that of ORA and detect the effect of state of refraction, corneal topography and central corneal thickness (CCT) on these measurements. Patients and Methods This cross-sectional study was done from March 2018 to October 2018 on 65 eyes of patients visiting the outpatient clinic. Results The mean GAT IOP was 15.938 ± 6.041 while the mean ORA (IOPcc) and (IOPg) were 19.711 ± 7.59 and 17.242 ± 7.35 mm Hg respectively. There is a strong positive relationship between GAT IOP & ORA IOPg measurement (r = 0.880 – p = <0.001*). Also finding a weak yet significant correlation between IOPg and CCT (r = 0.385, p = 0.001). None of the pressure measurements was affected by refraction or corneal curvature significantly. Conclusion In conclusion, our results suggest that mean IOPs obtained by ORA were significantly higher than that of GAT with different influencing factors that are not completely understood. caution has to be sought when using the ORA, the values obtained ought not to be used interchangeably with the values obtained by 1 GAT, despite the presence of a positive correlation between these values. This underlines the importance of using one and only method of evaluation of the IOP for every patient in successive follow-up visits.

scholarly journals Usefulness of the Non-Contact Tonometry in Out-Patient Screening

2016 ◽  
Vol 15 (2) ◽  
Author(s):  
Satheesh Solomon T Selvin ◽  
Chris Elsa Samson Jacob ◽  
Thomas Kuriakose
Keyword(s):  
Central Corneal Thickness ◽  
Care Center ◽  
Corneal Thickness ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Applanation Tonometry ◽  
Cross Sectional ◽  
Significant Difference ◽  
Iop Measurement ◽  
The Mean

Purpose: Goldmann applanation tonometry (GAT) is considered the gold standard for Intraocular Pressure (IOP) measurement. It has the disadvantages of being a contact device, need for a slit-lamp, non-portability and need of a skilled examiner. Many hospitals are using a Non Contact Tonometry (NCT) as a screening device to save clinician time, however the usefulness is not proved in terms of reliability. This study was aimed to determine the usefulness of the Air-puff tonometer (TONOREF NIDEK II, NIDEK CO., LTD., JAPAN) over a GAT in a tertiary care center. Design: Cross-sectional Study Methods: This was a cross-sectional, non interventional observational study conducted on 224 eyes (right eye) from 224 patients. All patients underwent the IOP measurement with both methods and a central corneal thickness (CCT) measured. The data was analyzed using SPSS 20.0 software. Results: The mean age of the patients was 40.3±11.29 years. There was a statistically significant difference (p<0.001) between the mean NCT and GAT readings which persisted even after correction for central corneal thickness. The correlation between NCT and GAT using Pearson’s correlation coefficient was strong irrespective of the corrections for their corneal thickness (r = 0.751 and 0.718 for uncorrected and corrected values respectively). The correlation of the individual clinicians for the readings varied from moderate to strong. The ROC curve showed the best sensitivity and specificity to occur at around 13 to 14 mmHg. Conclusion: NCT seems to overestimate the IOP at low ranges as compared to the GAT and underestimate at higher ranges. The crossover of the values is seen between 12 to 13 mmHg.  The clinician should do an individualized analysis of his/her GAT measurements to the readings of the NCT machine at the clinic to obtain clinician specific nomogram. 

scholarly journals Association of rs 10038177 and rs 1971050 Polymorphism of WDR 36 Gene with Clinical Profile in POAG Patients

2021 ◽  
Vol 28 (4) ◽  
pp. 433-439
Author(s):  
Mehvish MALIK ◽  
◽  
Tariq KHAN ◽  
Luxmi SINGH ◽  
Tasleem RAZA ◽  
...  
Keyword(s):  
Open Angle Glaucoma ◽  
Cross Sectional Study ◽  
Chi Square ◽  
Cross Sectional ◽  
Rnfl Thickness ◽  
Comparison Results ◽  
Pcr Rflp ◽  
Applanation Tonometer ◽  
Iop Measurement ◽  
The Mean

Aim: To study WDR36 gene polymorphism (rs10038177 , rs1971050) and its association with clinical parameters in patients of primary open angle glaucoma. Methods: A cross sectional study conducted on 105 cases of POAG to study its association with WDR36 gene polymorphisms (rs 10038177, rs 1971050). The study subjects underwent complete ophthalmic examination, slit lamp examination, IOP measurement by Goldmann’s Applanation Tonometer, gonioscopy, fundus evaluation by 90D lens. RNFL thickness was measured using cirrus 500 OCT by Carl Zeiss. Peripheral blood samples were collected in EDTA-anticoagulant tubes, then DNA was extracted using the genomic DNA extraction and genotyped by PCR-RFLP by using (AluI) enzyme.Data analysis by SPSS, version 21.0. Chi-square and Independent sample ‘t’-tests used for comparison. Results: The association of genotypic expression of rs10038177 polymorphism with different clinical variables in POAG patients, and the mean IOP (31.66 + 5.88) and CDR (0.72+ 0.15) for heterozygous genotype TC was significantly higher as compared to homozygous de33eeeee4(p<0.05) while in rs1971050 polymorphism, Diabetic history was significantly higher in genotype TC(60%)(p=0.012) as compared to genotype TT (19.1%). Conclusion: Our study shows that WDR 36 polymorphism (rs10038177) and (rs1971050) have an association with higher IOP and RNFL thinning which could be the underlying factors in pathogenesis and progression of POAG.

Comparison of Intraocular Pressure Measurement between Non-Contact and Goldmann Applanation Tonometry among Glaucoma Patients in Ratchaburi Hospital

2020 ◽  
Vol 103 (8) ◽  
pp. 819-823
Keyword(s):  
Intraocular Pressure ◽  
Outpatient Clinic ◽  
Pressure Measurement ◽  
Applanation Tonometry ◽  
Goldmann Applanation Tonometry ◽  
Mean Difference ◽  
Goldmann Applanation Tonometer ◽  
Applanation Tonometer ◽  
Iop Measurement ◽  
The Mean

Objective: To compare the intraocular pressure (IOP) values acquired from the non-contact tonometers and a Goldmann applanation tonometer in glaucoma patients. Materials and Methods: The present study included 300 eyes from 150 participants that attended the glaucoma outpatient clinic. The IOP was measured using both non-contact tonometry (NCT) and Goldmann applanation tonometry (GAT). The differences in IOP readings between the two techniques were evaluated. Results: The mean IOP as measured by NCT was 16.26±6.95 mmHg, when that of measured by GAT was 16.11±8.43 mmHg. The mean difference between the two techniques of measurement was 0.147±3.01 mmHg. The values acquired from NCT were slightly higher than those acquired by GAT in 49% of patients, and this difference was more distinct when the IOP as measured by GAT more than 21 mmHg. Conclusion: There was no statistically significant correlation in the measurement of IOP between non-contact and GAT tonometers. NCT is a proper method for mass screenings of IOP even if the IOP measurement by NCT is slightly higher than by GAT. Keywords: Tonometry, Comparison, Glaucoma, Non-contact tonometry, Goldmann applanation tonometerv

scholarly journals Comparative study of intraocular pressure (IP) in Bangladeshi individuals by contact and non contact technique

2016 ◽  
Vol 8 (1) ◽  
pp. 56
Author(s):  
Sayed Abdul Wadud ◽  
Md. Sharfuddin Ahmad ◽  
Muntasir Bin Shahid
Keyword(s):  
Intraocular Pressure ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Contact Method ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Goldmann Applanation Tonometer ◽  
Applanation Tonometer ◽  
The Mean ◽  
The Difference

<p><strong>Background:</strong> Intraocular pressure (IOP) is one of the most important parameters in the diagnosis and treatment of glaucoma. Glaucoma has been established as the second leading cause of blindness. The treatment of glaucoma focuses mainly on lowering intraocular pressure (IOP). The target IOP is often set to a level 20% to 30% of IOP reduction, and consequent large IOP reduction beyond 30% or even 40% in cases of advanced glaucoma The different methods of tonometery are: Goldman Applanation tonometery, Noncontact (air-puff) tonometery, Perkins tonometery, Tonopen tonometery, Transpalpebral tonometery.</p><p><strong>Objective:</strong> To determine the frequency of accuracy of intraocular pressure (IOP) measured by non-contact (air puff) tonometer compared with Goldmann applanation tonometer.</p><p><strong>Methods:</strong> This was a non-interventional, cross sectional study conducted at a tertiary care centre of Dhaka, Bangladesh. consecutive subjects attending the BSMMU eye OPD were included in the study. IOP was measured by non-contact (air puff) tonometer and a slit lamp mounted GAT in all the subjects. The study samples were selected by convenience sampling who presented for check-up in the Eye Department of community ophthalmology, Bangabandhu Sheikh Mujib Medical University, Dhaka. Bangladesh. Results:A total of 120 eyes in 60 patients were studied. The mean age of the patients was 41.60 year. study population consisted of 24 (40 %) men and 36 (60 %) women. The mean intraocular pressure was 13.52 &amp;13.72 mmHg for GAT, and 16.64 &amp; 17.44 mmHg for Air puff respectively. The range of measurements by GAT was from 10 to 23 mmHg and by Air puff was 12 to 28mmHg. The difference between IOP measured by two instruments were statistically significant (p=0.000).</p><p><strong>Conclusion:</strong> Airpuff tonometer is quick, a non-contact method to measure intraocular pressure and is useful for screening purposes and postoperative case but the measurements should be confirmed with Goldmann applanation tonometer for accurate labelling of intraocular pressure.</p>

scholarly journals Comparability of three intraocular pressure measurement: iCare pro rebound, non-contact and Goldmann applanation tonometry in different IOP group

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Min Chen ◽  
Lina Zhang ◽  
Jia Xu ◽  
Xinyi Chen ◽  
Yuxiang Gu ◽  
...  
Keyword(s):  
Intraocular Pressure ◽  
Pearson Correlation ◽  
Linear Regression Analysis ◽  
Corneal Thickness ◽  
Intraclass Correlation ◽  
Cross Sectional Study ◽  
Applanation Tonometry ◽  
Cross Sectional ◽  
Wide Range ◽  
Iop Measurement

Abstract Background Measurement of intraocular pressure (IOP) is essential for glaucoma patients. Many factors such as central corneal thickness (CCT) can affect the accuracy of IOP measurement. The purpose of this study was to evaluate the agreement of IOP measured by non-contact tonometer (NCT), iCare pro rebound tonometer (iCare), and Goldmann applanation tonometer (GAT) in different IOP group. Methods This was a Hospital-based cross-sectional study. Two hundred subjects were enrolled in this study. All subjects underwent IOP measurement using an NCT–iCare–GAT sequence. Bland-Altman, Pearson correlation and intraclass correlation analysis were performed using SPSS 17.0 software. The influence of CCT on each IOP measurement methods was evaluated by linear regression analysis. Results The mean difference (Δ) of NCT–GAT did not differ from (Δ) iCare–GAT in IOP < 10 and 10–21 mmHg group. However, (Δ) NCT–GAT was significantly higher than (Δ) iCare–GAT in IOP 22–30 and > 30 mmHg group (P < 0.05). Bland–Altman analysis showed significant agreement between the three devices (P < 0.01). IOP measurements of the three methods were significantly correlated with CCT (P < 0.01). Conclusions ICare pro shows a higher agreement with GAT over a wide range of IOP compared with NCT. The consistency between the three tonometers was similar in a low and normal IOP range. However, NCT shows a greater overestimate of IOP in moderate and higher IOP group. The variability of IOP measurement affected by CCT is NCT > iCare pro > GAT.

scholarly journals Pattern ERG as a predictor in ocular hypertensive

2016 ◽  
Vol 15 (2) ◽  
Author(s):  
Paaraj Dave ◽  
Jitendra Jethani
Keyword(s):  
Amplitude Ratio ◽  
Corneal Thickness ◽  
Visual Fields ◽  
Cross Sectional Study ◽  
Control Group ◽  
Study Group ◽  
Pattern Erg ◽  
Check Size ◽  
Cross Sectional ◽  
The Mean

Purpose: To report the repeatability of Pattern Electrotretinogram (PERG) and its findings in ocular hypertension (OHT) and normal eyes.Methods: A cross-sectional study where PERG responses were compared between the study group comprising of 80 eyes of 80 patients with intraocular pressure (IOP)>21 mmHg and the control group with 80 eyes of 80 normal individuals (IOP≤21mmHg). The optic disc and the visual fields were normal with a visual acuity of ≥ 0.8 in both groups. PERG was recorded twice for each individual in the control group by a single operator on 2 consecutive days to assess the repeatability.Results: The mean age in the study and control groups was 50.05±10.03 and 54.8±7.66 years(p=0.44) respectively. The mean IOP was 26.55±3.9 mmHg for the study group as opposed to 14.45±2.9 mmHg for the controls (p<0.001). The central corneal thickness and the cup-disc ratio was similar between the groups (p>.05). The P50-N95 amplitude (p=0.01) and the P50 latency (p<0.001) was statistically significantly different between both the groups. The intra-class correlation coefficient (ICC) showed poor agreement for all parameters except for N35-P50 0.8 to 16 degree check size amplitude ratio (PERG ratio).Conclusion:  Increase in P50 latency emerges as a new candidate for early glaucoma indicator in addition to reduction in P50-N95 amplitude. PERG parameters suffer from high test-retest variability. Deterioration in PERG recordings should be interpreted with caution. The variability is lesser for the PERG ratio which maybe more meaningful while monitoring for change over time.

scholarly journals The pattern of central corneal thickness in patients attending a Tertiary Hospital in Dar-Es-Salaam

2021 ◽  
Vol 9 (2) ◽  
pp. 127-133
Author(s):  
Annamary Stanislaus ◽  
Ntsilane Susan Mosenene ◽  
Celina Mhina ◽  
John Stanslaus Kisimbi ◽  
Frederick Robert Burgess ◽  
...  
Keyword(s):  
Central Corneal Thickness ◽  
Corneal Thickness ◽  
Dar Es Salaam ◽  
Applanation Tonometry ◽  
P Value ◽  
Muhimbili National Hospital ◽  
National Hospital ◽  
Cross Sectional ◽  
Significant Difference ◽  
The Mean

Background: Central Corneal Thickness (CCT) is an indicator of corneal health status as well as being an essential tool in assessment and management of corneal diseases. It is an important factor in the diagnosis and management of glaucoma as it affects the measurement of intraocular pressure. However, the pattern of central corneal thickness in our population is not known. Our study aimed to describe the CCT measurements and their variation with age and sex among patients attending the eye clinic at Muhimbili National Hospital (MNH), in Dar es Salaam, Tanzania. Methodology: A hospital-based descriptive, cross-sectional study used convenient sampling to recruit adult patients aged 18 years and above, presenting to the MNH between August 2016 and January 2017.Visual acuity assessment, Goldman applanation tonometry and CCT assessment using an ultrasound pachymeter were performed. Patients with previous intraocular surgery were excluded. Results: A total of 398 patients (208 males and 190 females) were recruited. The mean CCT was 526.64±38.30 µm; being 523.99±38.20 µm for males and 529.7±38.3 µm for females. 226 (56.85%) had CCT of less than 520 µm.There was no statistically significant difference in CCT between gender. The proportion of patients with thinner CCT increased with increasing age from 25.8% in those < 30 years to 75% in those aged 71years and above. The mean CCT decreased with increasing age with P-value<0.001. Conclusion: The average CCT in patients attending Muhimbili National Hospital is 526.64 µm (SD 38.30) which is generally thin, inversely proportion to age and similar that of other Africans and African-Americans. This finding has implications for the management of glaucoma in this population.

scholarly journals Intraocular Pressure Measurement Using Ocular Response Analyzer, Dynamic Contour Tonometer, and Scheimpflug Analyzer Corvis ST

2019 ◽  
Vol 2019 ◽  
pp. 1-9
Author(s):  
Lisa Ramm ◽  
Robert Herber ◽  
Eberhard Spoerl ◽  
Frederik Raiskup ◽  
Lutz E. Pillunat ◽  
...  
Keyword(s):  
Intraocular Pressure ◽  
Healthy Subjects ◽  
Corneal Thickness ◽  
Applanation Tonometry ◽  
Ocular Response Analyzer ◽  
Corvis St ◽  
Dynamic Contour Tonometer ◽  
Iop Measurement ◽  
Good Agreement

Purpose. To compare intraocular pressure (IOP) measurements with Goldmann applanation tonometry (GAT), ocular response analyzer (ORA), dynamic contour tonometer (DCT), and Corvis ST (CST) in healthy subjects. Methods. In a prospective, observational study, IOP measurements with GAT (GAT-IOPc), ORA (IOPcc), DCT (DCT-IOP), and CST (bIOP) were performed and analyzed in 94 healthy subjects. Results. Mean age of the participants was 45.6 ± 17.2 years (range 18 to 81 years). Mean GAT-IOPc was 12.9 ± 2.4 mmHg, mean DCT-IOP was 16.1 ± 2.6 mmHg, and mean IOPcc was 15.6 ± 3.3 mmHg. DCT-IOP and IOPcc were significantly higher than GAT-IOPc (P<0.001). Mean bIOP was 13.5 ± 2.4 mmHg that was slightly higher but not significantly different from GAT-IOPc (P=0.146). Correlation analysis of IOP values and central corneal thickness (CCT) revealed a negative correlation between GAT-IOPc and CCT (r = −0.347; P=0.001). However, IOPcc, DCT-IOP, and bIOP showed no significant correlation to CCT. Only bIOP revealed a weak but significant age dependency (r = 0.321, P=0.002). Conclusion. All tonometry devices showed a good agreement of biomechanical corrected IOP values with GAT-IOPc. As no influence of CCT on IOPcc, DCT-IOP, and bIOP was detectable, the used correction algorithms appear to be appropriate in these tonometers in the clinical setting. The highest agreement was found between GAT-IOPc and bIOP. However, bIOP weakly correlated with participants’ age. Further studies are needed to elucidate the role of bIOP for IOP measurement.

Self-measurement with Icare HOME tonometer, patients’ feasibility and acceptability

2019 ◽  
Vol 30 (2) ◽  
pp. 258-263 ◽  
Author(s):  
Barbara Cvenkel ◽  
Makedonka Atanasovska Velkovska ◽  
Vesna Dimovska Jordanova
Keyword(s):  
Intraocular Pressure ◽  
Central Corneal Thickness ◽  
Corneal Thickness ◽  
Pressure Data ◽  
Limits Of Agreement ◽  
Goldmann Applanation Tonometer ◽  
Applanation Tonometer ◽  
Perception Of Self ◽  
The Mean

Purpose: To evaluate and compare the accuracy of self-measurement of intraocular pressure using Icare Home rebound tonometer with Goldmann applanation tonometer and assess acceptability of self-tonometry in patients with glaucoma and ocular hypertension. Methods: In the study, 117 subjects were trained to use Icare Home for self-measurement. Icare Home tonometer readings were compared with Goldmann applanation tonometer, including one eye per patient. Agreement between the two methods of measurement was evaluated by Bland and Altmann analysis. Questionnaire was used to evaluate patients’ perception of self-tonometry. Results: One hundred and three out of 117 patients (88%) were able to measure their own intraocular pressure and 96 (82%) fulfilled the requirements for certification. The mean (SD) difference Goldmann applanation tonometer minus Icare Home was 1.2 (2.4) mmHg (95% limits of agreement, –3.4 to 5.9 mmHg). The magnitude of bias between the two methods depended on central corneal thickness, with greater bias at central corneal thickness <500 µm. In 65 out of 96 subjects (67.7%), Icare Home results were within 2 mmHg of the Goldmann applanation tonometer. Seventy-three out of 93 (78.5%) felt that self-tonometry was easy to use and 75 patients (80.6%) responded that they would use the device at home. Conclusion: Icare Home tonometry tends to slightly underestimate intraocular pressure compared to Goldmann applanation tonometer. Most patients were able to perform self-tonometry and found it acceptable for home use. Measurements using rebound self-tonometry could improve the quality of intraocular pressure data and optimize treatment regimen.

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