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Determining Significant Elevation of Intraocular Pressure Using Self-tonometry
- Source :
- Optometry and Vision Science. 97:86-93
- Publication Year :
- 2020
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2020.
-
Abstract
- SIGNIFICANCE Icare HOME rebound tonometry is increasingly adopted into clinical practice for IOP phasing of glaucoma patients and suspects. Because of measurement differences with applanation tonometry and diurnal fluctuations, interpretation of the IOP measured with Icare HOME phasing can be challenging. PURPOSE The purpose of this study was to use a large patient cohort to develop a practical, analytical tool for interpreting Icare HOME measurements with respect to applanation pressure. METHODS IOP measurements using the Icare HOME and an applanation tonometer were taken prospectively in 498 consecutive patients. Bland-Altman, frequency distribution, and linear regression analysis were applied to determine measurement differences. A novel criterion, Threshold Icare HOME IOP, was developed to assist identification of elevation above target applanation pressure, considering the expected diurnal variation and measurement variability. RESULTS Icare HOME tended to underestimate applanation tonometry (mean bias, -1.7 mmHg; 95% limits of agreement, -7.0 to +3.6). Overall, differences were within ±3 mmHg in 71.5% and ±5 mmHg in 92% of patients. Based on the novel criterion developed, Icare HOME measurements that exceed target applanation pressure by 6 mmHg or greater are generally outside the 95% limit of expected observations. CONCLUSIONS The Threshold Icare HOME IOP is a novel and practical criterion that can assist clinicians in their interpretation of Icare HOME phasing measurements with respect to target applanation pressures. Elevation above the expected thresholds may prompt closer monitoring or even modifications to glaucoma management.
- Subjects :
- Adult
Male
Applanation tonometry
Intraocular pressure
genetic structures
Glaucoma
Significant elevation
Tonometry, Ocular
03 medical and health sciences
0302 clinical medicine
Humans
Medicine
Prospective Studies
Intraocular Pressure
Aged
Monitoring, Physiologic
Measurement variability
business.industry
Self tonometry
Applanation tonometer
Reproducibility of Results
Middle Aged
medicine.disease
Self Care
Clinical Practice
Ophthalmology
Cross-Sectional Studies
030221 ophthalmology & optometry
Optometry
Female
Ocular Hypertension
business
030217 neurology & neurosurgery
Subjects
Details
- ISSN :
- 15389235 and 10405488
- Volume :
- 97
- Database :
- OpenAIRE
- Journal :
- Optometry and Vision Science
- Accession number :
- edsair.doi.dedup.....8e461204f0795d004489bb87d7dd590a