Monitoring daily intraocular pressure fluctuations with self‐tonometry in healthy subjects

Quérat, Laurence; Chen, Enping

doi:10.1111/aos.13389

Cited by 25 publications

(25 citation statements)

References 24 publications

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“…It aims to record diurnal changes of IOP and detect any IOP spikes that occur outside office hours. Several studies reported Icare rebound tonometry to be valuable in managing paediatrics and adult patients . It is well‐tolerated by the majority of patients and offers reliable IOP measurement which correlates with the GAT …”

Section: Introductionmentioning

confidence: 99%

Using Icare HOME tonometry for follow‐up of patients with open‐angle glaucoma before and after selective laser trabeculoplasty

Awadalla

Qassim

Hassall

et al. 2019

Clinical Exper Ophthalmology

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Importance: Monitoring the results of selective laser trabeculoplasty (SLT) on intraocular pressure (IOP) using a home rebound tonometry. Background: To evaluate the role of Icare HOME tonometry in open-angle glaucoma patients being treated with SLT. Design: A clinic-based prospective case study. Participants: Fourteen eyes from 14 patients diagnosed with primary openangle glaucoma were recruited.Methods: The trabecular meshwork of each eye was treated 360 with a frequency-doubled Q-switched Nd:YAG laser. IOP was measured four times a day for a week before and after SLT. On the day of SLT, the patients were required to measure the IOP in the evening to record any IOP spikes. Main Outcome Measures: The use of Icare HOME in following up patients post-laser trabeculoplasty without the need for clinic attendance. Results: Icare HOME recorded a significant reduction of 5.12 mmHg in the mean IOP post-SLT (95% confidence interval [CI] 3.75-6.50 mmHg, P < .001).The maximum IOP was also reduced by 6.14 mmHg (95% CI 3.07-9.21, P < .001) with no IOP spikes recorded post-SLT. There was a reduction in IOP fluctuation post-SLT by 1.07 mmHg (95% CI 0.24-1.89 mmHg, P = .021). No adverse effects for using the Icare HOME were reported by the study participants. Conclusions and Relevance: This methodology could be highly useful for facilitating safe follow-up of patients residing in remote and rural areas, thus reducing healthcare cost with better information on IOP. K E Y W O R D S open-angle glaucoma, rebound tonometry, selective laser trabeculoplasty Mona S. Awadalla and Ayub Qassim contributed equally to the work.

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Section: Introductionmentioning

confidence: 99%

Using Icare HOME tonometry for follow‐up of patients with open‐angle glaucoma before and after selective laser trabeculoplasty

Awadalla

Qassim

Hassall

et al. 2019

Clinical Exper Ophthalmology

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“…In recent years, self-administered rebound tonometry performed without topical anaesthesia has been investigated for use in diurnal intraocular pressure monitoring. 21 , 22 First, the iCare ONE and more recently the iCare HOME (iCare Finland Oy, Vantaa, Finland) have demonstrated good repeatability and correlation with Goldmann applanation tonometry in both healthy persons and glaucoma patients. 23 – 26 With appropriate training and instruction, most patients were able to successfully perform self-tonometry with the advantage of obtaining intraocular pressure measurements in the patient's habitual environment and fewer visits to the health practitioner's office.…”

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confidence: 99%

“… 24 , 25 Previous reports investigating diurnal intraocular pressure with rebound self-tonometry have demonstrated high intraindividual variation across consecutive days, with participants exhibiting different diurnal curve patterns from day to day. 21 , 22 However, no studies to date have investigated diurnal curve fluctuations with iCare HOME for more than a week.…”

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confidence: 99%

Diurnal Intraocular Pressure Fluctuations with Self-tonometry in Glaucoma Patients and Suspects: A Clinical Trial

et al. 2018

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SIGNIFICANCEThis article shows that self-tonometry can provide robust measures of diurnal intraocular pressure (IOP) and also detect changes to IOP in response to treatment within a short period of monitoring. These advances in IOP monitoring may contribute to improved management of glaucoma patients and suspects.PURPOSEThe aim of this study was to prospectively investigate the utility of rebound self-tonometry performed over several weeks for detecting diurnal IOP fluctuations in glaucoma patients and suspects and also initial response to topical treatment in glaucoma patients.METHODSForty patients were recruited following glaucoma-specific examination. Subsequent to successful training with the iCare HOME tonometer, patients were instructed to measure IOP, in a sitting position, four times a day over 4 to 6 weeks. Date, time, laterality, and IOP downloaded from the tonometer and clinical examination data, including applanation IOP and corneal thickness, were analyzed. A user satisfaction survey was also administered at study completion. t Test and analysis of variance were used to compare groups and IOP across days. Pearson correlation was used to compare measurements to Goldmann applanation tonometry and IOP measurements from the first day/s to the overall mean IOP.RESULTSTwenty-seven patients (18 suspects and 9 glaucoma patients) completed data collection. Patients self-measured IOP on 118 (±29) occasions for 40 (±7.4) days. Two dominant patterns of fluctuation were revealed: peak IOP upon awakening (n = 11) and at midday (n = 13). Diurnal IOP measured in the first 7 days showed strong correlation to diurnal IOP across the entire study period (r2 = 0.82, P < .0001). Within 24 hours of treatment commencement (latanoprost 0.005% ophthalmic solution), IOP reduced from 23.9 (±5.2) to 16.1 (±2.6) mmHg. Overall, patients rated the instrument as easy to use, although difficulties with correct alignment were expressed.CONCLUSIONSRebound self-tonometry demonstrated utility for measuring diurnal IOP fluctuations in most patients, hence enhancing management of patient with or at risk of developing glaucoma.

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“…Thanks to the up come of a new self-tonometer, iCare Home Ò , ophthalmologists have now the possibility to gather more information on the IOP. Many studies have shown that iCare Home Ò is a reliable device (Tarkkanen et al 2010;Chen et al 2016;Pronin et al 2017;Querat & Chen 2017;Tarkkanen & Kivela 2018). Motivated patients or a suitable accompanying person can be trained to perform home tonometry.…”

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confidence: 99%

Clinical Use of iCare Home^® tonometer

Quérat

Chen

2019

Acta Ophthalmologica

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Monitoring daily intraocular pressure fluctuations with self‐tonometry in healthy subjects

Abstract: Rebound self-tonometry appears to be accurate and could be used to monitor short- and long-term IOP variations. The difference between IOP patterns on consecutive days raises questions as to the certainty of a single IOP measurement as a measure of treatment effect.

Cited by 25 publications

References 24 publications

Using Icare HOME tonometry for follow‐up of patients with open‐angle glaucoma before and after selective laser trabeculoplasty

Using Icare HOME tonometry for follow‐up of patients with open‐angle glaucoma before and after selective laser trabeculoplasty

Diurnal Intraocular Pressure Fluctuations with Self-tonometry in Glaucoma Patients and Suspects: A Clinical Trial

Clinical Use of iCare Home^® tonometer

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Monitoring daily intraocular pressure fluctuations with self‐tonometry in healthy subjects

Abstract: Rebound self-tonometry appears to be accurate and could be used to monitor short- and long-term IOP variations. The difference between IOP patterns on consecutive days raises questions as to the certainty of a single IOP measurement as a measure of treatment effect.

Cited by 25 publications

References 24 publications

Using Icare HOME tonometry for follow‐up of patients with open‐angle glaucoma before and after selective laser trabeculoplasty

Using Icare HOME tonometry for follow‐up of patients with open‐angle glaucoma before and after selective laser trabeculoplasty

Diurnal Intraocular Pressure Fluctuations with Self-tonometry in Glaucoma Patients and Suspects: A Clinical Trial

Clinical Use of iCare Home® tonometer

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Clinical Use of iCare Home^® tonometer