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Abstract #49187 Published in IGR 14-1
Factors Influencing Intermethod Agreement Between Goldmann Applanation, Pascal Dynamic Contour, and Ocular Response Analyzer Tonometry
Sullivan-Mee M; Lewis SE; Pensyl D; Gerhardt G; Halverson KD; Qualls CJournal of Glaucoma 2013; 22: 487-495
PURPOSE: To examine factors that influence intraocular pressure (IOP) measurement agreement between Goldmann applanation (GAT), Ocular Response Analyzer (ORA), and Pascal Dynamic Contour tonometers (DCT). PATIENTS AND METHODS: In subjects who were diagnosed with primary open-angle glaucoma, ocular hypertension, glaucoma suspect, and normal, we used ORA, DCT, and GAT to obtain corneal hysteresis (CH), corneal resistance factor (CRF), ocular pulse amplitude, and 4 IOP values (ORA-IOPcc; ORA-IOPg; DCT-IOP; and GAT-IOP.) We also obtained corneal curvature, corneal thickness, axial length, retinal nerve fiber layer thickness, visual field parameters, diabetes diagnostic status, and topical IOP-lowering treatment data. Analysis of variance, Bland-Altman, and regression analyses were used to examine IOP agreement and associated factors. RESULTS: In 243 eyes of the 243 subjects, mean DCT-IOP (18.73±4.92) was not different from mean ORA-IOPcc (18.96±5.41) but both were significantly higher than ORA-IOPg (16.97±5.49) and GAT-IOP (16.37±4.97). In multivariate regression models, intermethod differences between IOPg, IOPcc, and DCT-IOP were explained almost completely by variations in CH, CRF, and level of IOP (r=0.98 to 0.99); conversely, intermethod variability between GAT-IOP and the other 3 IOP metrics was only partially explained by the factors evaluated in this study (r=0.31 to 0.65). CONCLUSIONS: Consistent with other studies, we found that the 4 IOP variables examined in this study are not interchangeable. The most consistent confounders of IOP measurement agreement were the ORA-measured corneal parameters, CH and CRF. Thus, accounting for these factors may be important in efforts to obtain accurate transcorneal estimates of IOP.
Albuquerque VA Medical Center, University of New Mexico, Albuquerque, NM, USA.
Full articleClassification:
6.1.1 Devices, techniques (Part of: 6 Clinical examination methods > 6.1 Intraocular pressure measurement; factors affecting IOP)
