Aachal Kotecha1, Ahmed Elkarmouty2, Csilla Ajtony2, Keith Barton3. 1. Glaucoma Service, Moorfields Eye Hospital NHS Foundation Trust, London, UK NIHR Biomedical Research Centre for Ophthalmology, UCL Institute of Ophthalmology and Moorfields Eye Hospital NHS Foundation Trust, London, UK. 2. Glaucoma Service, Moorfields Eye Hospital NHS Foundation Trust, London, UK. 3. Glaucoma Service, Moorfields Eye Hospital NHS Foundation Trust, London, UK NIHR Biomedical Research Centre for Ophthalmology, UCL Institute of Ophthalmology and Moorfields Eye Hospital NHS Foundation Trust, London, UK Department of Epidemiology and Genetics, UCL Institute of Ophthalmology, London, UK.
Abstract
PURPOSE: To compare agreement between ophthalmologists and non-ophthalmologists (nurses and ophthalmic technicians) when measuring the intraocular pressure (IOP) using Goldmann applanation tonometry (GAT) and Pascal dynamic contour tonometry (DCT). METHODS: Patients attending for their routine glaucoma outpatient appointment were invited to participate. IOP was measured in one eye by either two ophthalmologists (observer group 1), two non-ophthalmologists (observer group 2) or one ophthalmologist and one non-ophthalmologist (observer group 3). All were experienced in using GAT and some experienced in using the DCT. The order of tonometer and staff was randomised. Agreement was calculated by Bland-Altman analysis, with the mean difference and 95% limits of agreement (LoA) of measurements calculated for each observer group. RESULTS: One hundred eyes were measured within each observer group. The mean difference (95% LoA) in IOP measurements were GAT: group 1=-0.20 (4.9) mm Hg, group 2=0.6 (5.4) mm Hg and group 3=0.0 (3.7) mm Hg; DCT: group 1=0.8 (7.7) mm Hg, group 2=0.3 (4.2) and group 3=0.0 (5.2) mm Hg. The DCT consistently over-read the GAT for all observer groups. DISCUSSION/ CONCLUSIONS: Ophthalmologists show good levels of agreement with each other when using GAT, while technicians/nursing staff show better agreement when using the DCT. The DCT may be a better tonometer to use if permanently delegating IOP measurements to non-ophthalmologists, but measurements cannot be interchanged with the GAT. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
PURPOSE: To compare agreement between ophthalmologists and non-ophthalmologists (nurses and ophthalmic technicians) when measuring the intraocular pressure (IOP) using Goldmann applanation tonometry (GAT) and Pascal dynamic contour tonometry (DCT). METHODS: Patients attending for their routine glaucoma outpatient appointment were invited to participate. IOP was measured in one eye by either two ophthalmologists (observer group 1), two non-ophthalmologists (observer group 2) or one ophthalmologist and one non-ophthalmologist (observer group 3). All were experienced in using GAT and some experienced in using the DCT. The order of tonometer and staff was randomised. Agreement was calculated by Bland-Altman analysis, with the mean difference and 95% limits of agreement (LoA) of measurements calculated for each observer group. RESULTS: One hundred eyes were measured within each observer group. The mean difference (95% LoA) in IOP measurements were GAT: group 1=-0.20 (4.9) mm Hg, group 2=0.6 (5.4) mm Hg and group 3=0.0 (3.7) mm Hg; DCT: group 1=0.8 (7.7) mm Hg, group 2=0.3 (4.2) and group 3=0.0 (5.2) mm Hg. The DCT consistently over-read the GAT for all observer groups. DISCUSSION/ CONCLUSIONS: Ophthalmologists show good levels of agreement with each other when using GAT, while technicians/nursing staff show better agreement when using the DCT. The DCT may be a better tonometer to use if permanently delegating IOP measurements to non-ophthalmologists, but measurements cannot be interchanged with the GAT. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
Authors: Cassia Garcia Moraes Pagano; Tais de Campos Moreira; Daniel Sganzerla; Ana Maria Frölich Matzenbacher; Amanda Gomes Faria; Lucas Matturro; Felipe Cezar Cabral; Dimitris Rucks Varvaki Rados; Anelise Decavata Szortyka; Maicon Falavigna; Maria Eulalia Vinadé Chagas; Erno Harzheim; Marcelo Gonçalves; Roberto Umpierre; Aline Lutz de Araujo Journal: PLoS One Date: 2021-11-30 Impact factor: 3.240