F Carbonaro1, T Andrew, D A Mackey, T D Spector, C J Hammond. 1. Twin Research and Genetic Epidemiology Unit, King's College London School of Medicine and St. Thomas' Hospital Campus, London, UK. francis.carbonaro@btopenworld.com
Abstract
PURPOSE: The purpose of this study was to compare the reliability of the 'gold standard' Goldmann applanation tonometer (GAT), with that of the ocular response analyser (ORA), and the dynamic contour tonometer (DCT). PATIENTS AND METHODS: A total of 694 subjects were recruited to participate from the TwinsUK (UK Adult Twin Registry) at St Thomas' Hospital, London. Intraocular pressure (IOP) was measured using GAT, ORA, and the DCT. The agreement between the three methods was assessed using the Bland-Altman method. Repeatability coefficients and coefficient of variation between first and second readings of the same eye were used to assess reliability. RESULTS: Mean age was 57.5 years (SD, 13.1; range, 16.1-88.5). The mean IOPs, calculated using the mean of two readings from the right eye were as follows: Goldmann (GAT), 14.1+/-2.8 mm Hg; IOPg (ORA), 15.9+/-3.2 mm Hg; IOPcc (ORA), 16.6+/-3.2 mm Hg; and DCT, 16.9+/-2.7 mm Hg. The 95% limits of agreement were for ORA (IOPcc): GAT, -2.07 to 7.18 mm Hg; for DCT: GAT, -0.49 to 6.21 mm Hg; and for DCT: ORA (IOPcc), -3.01 to 4.85 mm Hg. Coefficients of variation for the three tonometers were GAT, 8.3%; ORA, 8.2%; DCT, 6.3%. The repeatability coefficients were 3.4 mm Hg for GAT, 3.57 mm Hg for ORA and 3.09 mm Hg for DCT. GAT and ORA (IOPg) readings showed a positive correlation with central corneal thickness (P<0.005). CONCLUSIONS: This study found similar reliability in all three tonometers. Bland-Altman plots showed the three instruments to have 95% limits of agreement outside the generally accepted limits, which means they are not interchangeable. GAT measurements were found to be significantly lower than the two newer instruments.
PURPOSE: The purpose of this study was to compare the reliability of the 'gold standard' Goldmann applanation tonometer (GAT), with that of the ocular response analyser (ORA), and the dynamic contour tonometer (DCT). PATIENTS AND METHODS: A total of 694 subjects were recruited to participate from the TwinsUK (UK Adult Twin Registry) at St Thomas' Hospital, London. Intraocular pressure (IOP) was measured using GAT, ORA, and the DCT. The agreement between the three methods was assessed using the Bland-Altman method. Repeatability coefficients and coefficient of variation between first and second readings of the same eye were used to assess reliability. RESULTS: Mean age was 57.5 years (SD, 13.1; range, 16.1-88.5). The mean IOPs, calculated using the mean of two readings from the right eye were as follows: Goldmann (GAT), 14.1+/-2.8 mm Hg; IOPg (ORA), 15.9+/-3.2 mm Hg; IOPcc (ORA), 16.6+/-3.2 mm Hg; and DCT, 16.9+/-2.7 mm Hg. The 95% limits of agreement were for ORA (IOPcc): GAT, -2.07 to 7.18 mm Hg; for DCT: GAT, -0.49 to 6.21 mm Hg; and for DCT: ORA (IOPcc), -3.01 to 4.85 mm Hg. Coefficients of variation for the three tonometers were GAT, 8.3%; ORA, 8.2%; DCT, 6.3%. The repeatability coefficients were 3.4 mm Hg for GAT, 3.57 mm Hg for ORA and 3.09 mm Hg for DCT. GAT and ORA (IOPg) readings showed a positive correlation with central corneal thickness (P<0.005). CONCLUSIONS: This study found similar reliability in all three tonometers. Bland-Altman plots showed the three instruments to have 95% limits of agreement outside the generally accepted limits, which means they are not interchangeable. GAT measurements were found to be significantly lower than the two newer instruments.
Authors: Pirro G Hysi; Ching-Yu Cheng; Henriët Springelkamp; Stuart Macgregor; Jessica N Cooke Bailey; Robert Wojciechowski; Veronique Vitart; Abhishek Nag; Alex W Hewitt; René Höhn; Cristina Venturini; Alireza Mirshahi; Wishal D Ramdas; Gudmar Thorleifsson; Eranga Vithana; Chiea-Chuen Khor; Arni B Stefansson; Jiemin Liao; Jonathan L Haines; Najaf Amin; Ya Xing Wang; Philipp S Wild; Ayse B Ozel; Jun Z Li; Brian W Fleck; Tanja Zeller; Sandra E Staffieri; Yik-Ying Teo; Gabriel Cuellar-Partida; Xiaoyan Luo; R Rand Allingham; Julia E Richards; Andrea Senft; Lennart C Karssen; Yingfeng Zheng; Céline Bellenguez; Liang Xu; Adriana I Iglesias; James F Wilson; Jae H Kang; Elisabeth M van Leeuwen; Vesteinn Jonsson; Unnur Thorsteinsdottir; Dominiek D G Despriet; Sarah Ennis; Sayoko E Moroi; Nicholas G Martin; Nomdo M Jansonius; Seyhan Yazar; E-Shyong Tai; Philippe Amouyel; James Kirwan; Leonieke M E van Koolwijk; Michael A Hauser; Fridbert Jonasson; Paul Leo; Stephanie J Loomis; Rhys Fogarty; Fernando Rivadeneira; Lisa Kearns; Karl J Lackner; Paulus T V M de Jong; Claire L Simpson; Craig E Pennell; Ben A Oostra; André G Uitterlinden; Seang-Mei Saw; Andrew J Lotery; Joan E Bailey-Wilson; Albert Hofman; Johannes R Vingerling; Cécilia Maubaret; Norbert Pfeiffer; Roger C W Wolfs; Hans G Lemij; Terri L Young; Louis R Pasquale; Cécile Delcourt; Timothy D Spector; Caroline C W Klaver; Kerrin S Small; Kathryn P Burdon; Kari Stefansson; Tien-Yin Wong; Ananth Viswanathan; David A Mackey; Jamie E Craig; Janey L Wiggs; Cornelia M van Duijn; Christopher J Hammond; Tin Aung Journal: Nat Genet Date: 2014-08-31 Impact factor: 38.330
Authors: Abhishek Nag; Cristina Venturini; Kerrin S Small; Terri L Young; Ananth C Viswanathan; David A Mackey; Pirro G Hysi; Christopher Hammond Journal: Hum Mol Genet Date: 2014-02-11 Impact factor: 6.150