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1 General aspects (0)   1.1 Epidemiology (16)   1.2 Population genetics (1)   1.3 Pathogenesis (1)   1.4 Quality of life (7)   1.5 Glaucomas as cause of blindness (7)   1.6 Prevention and screening (9) 2 Anatomical structures in glaucoma (0)   2.1 Conjunctiva (5)   2.2 Cornea (21)   2.3 Sclera (3)   2.4 Anterior chamber angle (7)   2.5 Meshwork (0)     2.5.1 Trabecular meshwork (5)     2.5.2 Schlemms canal (2)     2.5.3 Scleral outlet channels (0)   2.6 Aqueous humor dynamics (3)     2.6.1 Production (0)     2.6.2 Outflow (0)       2.6.2.1 Trabecular meshwork (0)       2.6.2.2 Uveoscleral (1)     2.6.3 Compostion (2)   2.7 Episcleral veins and venous pressure (0)   2.8 Iris (7)   2.9 Ciliary body (1)   2.10 Lens (0)   2.11 Vitreous body (2)   2.12 Choroid, peripapillary choroid, peripapillary atrophy (2)   2.13 Retina and retinal nerve fibre layer (25)   2.14 Optic disc (20)   2.15 Optic nerve (2)   2.16 Chiasma and retrochiasmal central nervous system (2)   2.17 Stem cells (1)   2.20 Other (1) 3 Laboratory methods (0)   3.1 Microscopy (0)   3.2 Electron microscopy (0)   3.3 Immunohistochemistry (1)   3.4 Molecular genetics (1)     3.4.1 Linkage studies (2)     3.4.2 Gene studies (25)   3.5 Molecular biology incl. 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Miscellaneous (18)

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Abstract #26697 Published in IGR 12-3

iCare rebound tonometry for pediatric glaucomamanagement-clinic and home settings

Flemmons M; Dzau J; Freedman S
Journal of AAPOS 2010; 14: 17

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Introduction: Accurate intraocular pressure (IOP) measurement, important in managing pediatric glaucoma, often presents challenges. The iCare(registered trademark) rebound tonometer shows promise for screening normal children and in adults with glaucoma. The purpose of this study is to evaluate the iCare(registered trademark) tonometer in children with glaucoma. Methods: Retrospective chart review comparing iCare(registered trademark) vs. Tonopen/ Goldmann tonometry in pediatric glaucoma patients over two months and review of multiple diurnal IOPs by home iCare(registered trademark) tonometry for pediatric glaucoma patient pre- and post-Baerveldt glaucoma surgery. Ongoing prospective clinic study (n~100) comparing masked iCare vs. GAT/Tonopen; iCare(registered trademark) home tonometry portion to document true diurnal IOP variation(n~12). Results: 25 eyes (25 children) with pediatric glaucoma included in the retrospective study. Goldmann applanation tonometry(GAT, n=18) ranged from 6 to 29 mm Hg and Tonopen measurements(n = 7) ranged from 10 to 47 mm Hg. iCare(registered trademark) readings (n = 25) ranged from 8 to 41 mm Hg. Mean difference between iCare(registered trademark) and GAT was 2.9 + SD3.6 mm Hg, 95%CI (1.1,4.7); 67% of iCare(registered trademark) IOPs were within (plus or minus) 3 mm Hg of GAT. Mean difference between iCare(registered trademark) and Tonopen was -3.3 + SD 9.0 mm Hg, 95% CI (-10.2,3.6); 71% of iCare(registered trademark) IOPs were within (plus or minus)3 mm Hg of Tonopen. Home iCare(registered trademark) tonometry( 52readings over 4months) in a monocular 5-year-old child with aphakic glaucoma demonstrated IOP range18-43 mm Hg prior to, versus 9-21 mm Hg following successful Baerveldt glaucoma implantation. In 11 patients who participated in the iCare(registered trademark) home tonometry portion, diurnal IOP variation was demonstrated with maximum range of 22 mm Hg. Conclusions: The iCare(registered trademark)tonometer correlated well with GATand Tonopen tonometry in this pilot study, with iCare(registered trademark) overestimating GAT and underestimating Tonopen IOPs overall. iCare(registered trademark) home tonometry confirmed suspected large diurnal IOP variability pre-operatively, and its reduction after glaucoma surgery. iCare(registered trademark) tonometry holds promise in management of pediatric glaucoma, especially for home tonometry which has changed management for 2 patients in our series of 11, but departures from GAT/Tonopen IOPs may occur in selected cases and deserve further evaluation.

M. Flemmons.

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Classification:

6.1.1 Devices, techniques (Part of: 6 Clinical examination methods > 6.1 Intraocular pressure measurement; factors affecting IOP)
9.1.2 Juvenile glaucoma (Part of: 9 Clinical forms of glaucomas > 9.1 Developmental glaucomas)

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