Reproducibility of 5 Methods of Ocular Tonometry

Anne E Kutzscher; Rajesh S Kumar; B Ramgopal; Mahalakshmi V Rackenchath; Sathi Devi; Sriharsha Nagaraj; Caitlin A Moe; Dionna M Fry; Robert L Stamper; Jeremy D Keenan

doi:10.1016/j.ogla.2019.07.006

Reproducibility of 5 Methods of Ocular Tonometry

Ophthalmol Glaucoma. 2019 Nov-Dec;2(6):429-434. doi: 10.1016/j.ogla.2019.07.006. Epub 2019 Aug 6.

Affiliations

¹ Department of Ophthalmology, University of California, San Francisco, San Francisco, California; Medical Student, School of Medicine, Georgetown University, Washington, DC.
² Glaucoma Department, Narayana Nethralaya Eye Hospital, Bangalore, India.
³ Francis I. Proctor Foundation, University of California, San Francisco, San Francisco, California.
⁴ Department of Ophthalmology, University of California, San Francisco, San Francisco, California.
⁵ Department of Ophthalmology, University of California, San Francisco, San Francisco, California; Francis I. Proctor Foundation, University of California, San Francisco, San Francisco, California. Electronic address: jeremy.keenan@ucsf.edu.

PMID: 32672576
DOI: 10.1016/j.ogla.2019.07.006

Abstract

Purpose: To evaluate the agreement between Goldmann applanation tonometry (GAT; Haag-Streit, Bern, Switzerland) and several portable tonometers that could be used for glaucoma screening programs.

Design: Evaluation of a diagnostic test.

Participants: Three hundred twenty-one eyes of 168 participants seeking treatment at the glaucoma clinic of a tertiary eye hospital in India.

Methods: Participants underwent intraocular pressure (IOP) measurement with GAT and 4 index tests: the Icare TA01i rebound tonometer (Icare USA, Raleigh, NC), a noncontact tonometer (NCT; Topcon CT-80; Topcon; Tokyo, Japan), a pneumatonometer (Model 30; Reichert Technologies; Depew, NY), and the Tono-Pen AVIA (Reichert Technologies).

Main outcome measures: Estimates of reproducibility of IOP measurements between each index test and GAT, including the intraclass correlation coefficient (ICC) and the Bland-Altman 95% limits of agreement.

Results: The Icare showed the greatest agreement with GAT (ICC, 0.69; 95% confidence interval, 0.61-0.74), followed by the NCT (ICC, 0.65; 95% confidence interval, 0.58-0.71), the Tono-Pen (ICC, 0.51; 95% confidence interval, 0.43-0.59), and the pneumatonometer (ICC, 0.36; 95% confidence interval, 0.27-0.44). The pneumatonometer and Tono-Pen tended to overestimate IOP relative to GAT, with a mean difference of 3.4 mmHg (95% limits of agreement [LOA], -7.3 to 14.1 mmHg) for the pneumatonometer and 3.2 mmHg (95% LOA, -6.1 to 12.6 mmHg) for the Tono-Pen. In contrast, measurements from the Icare and NCT were on average within 1 point of those for GAT (mean difference, -0.4 mmHg [95% LOA, -8.4 to 7.6 mmHg] and -0.5 mmHg [95% LOA, -8.7 to 7.6 mmHg], respectively).

Conclusions: The Icare and NCT both demonstrated good agreement with GAT across a wide range of IOPs and could be considered for glaucoma screening programs.

Publication types

Evaluation Study
Research Support, Non-U.S. Gov't

MeSH terms

Cross-Sectional Studies
Female
Glaucoma / diagnosis*
Glaucoma / physiopathology
Humans
Intraocular Pressure / physiology*
Male
Middle Aged
Reproducibility of Results
Retrospective Studies
Tonometry, Ocular / methods*