Ocular Response Analyzer versus Goldmann Applanation Tonometry for Intraocular Pressure Measurements

Martinez-de-la-Casa, José M.; García‐Feijoó, Julián; Fernandez-Vidal, Ana; Méndez-Hernández, Carmen; García–Sánchez, J.

doi:10.1167/iovs.06-0158

Cited by 124 publications

(117 citation statements)

References 14 publications

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“…17 In a study by Pepose et al, 18 comparing the same three instruments, the DCT was the only tonometer that did not show a significant change in IOP measurement pre-and post-LASIK. The wide limits of agreement found in this study are similar to the literature for both ORA 17,19 and DCT. 20,21 There are conflicting findings in the literature regarding the difference in IOP measurement between GAT and ORA; our ORA IOPg measures were on average 1.8 mm Hg higher than the GAT pressures, similar to another study that found IOPcc to overestimate GAT by 1.7 mm Hg.…”

Section: Discussionsupporting

confidence: 89%

“…They proceeded to refine the calculation for IOPcc, calling this new value IOPccf (corneal constant factor) and this was found to have no association with CCT. 22 Another study, performed on patients undergoing glaucoma treatment showed that ORA readings were not independent of CCT, 19 although GAT was not correlated with CCT in this study, in contrast to most published studies. In the case of the DCT, the literature has consistently showed that IOP readings are less dependent on CCT than GAT, 21,25 and our study has re-confirmed the finding.…”

Section: Discussioncontrasting

confidence: 83%

“…17 Yet another study looking at 48 eyes of 48 patients found mean IOPg to be 7.2 mm Hg higher than GAT and IOPcc 8.3 mm Hg higher. 19 This study found a proportional bias between GAT and ORA; that is, as the IOP increased, the difference between ORA and GAT increased proportionately, with the ORA measures being even higher. There is conflicting evidence in the literature regarding proportional bias between these two instruments; two studies have reported a proportional bias, 17,19 with the difference between ORA and GAT increasing with higher IOP.…”

Section: Discussionmentioning

confidence: 57%

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Comparison of three methods of intraocular pressure measurement and their relation to central corneal thickness

Carbonaro

Andrew

Mackey

et al. 2010

Eye

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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, À2.07 to 7.18 mm Hg; for DCT: GAT, À0.49 to 6.21 mm Hg; and for DCT: ORA (IOPcc), À3.01 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 (Po0.005). 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.

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Section: Discussionsupporting

confidence: 89%

Section: Discussioncontrasting

confidence: 83%

Section: Discussionmentioning

confidence: 57%

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Comparison of three methods of intraocular pressure measurement and their relation to central corneal thickness

Carbonaro

Andrew

Mackey

et al. 2010

Eye

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“…7 Despite its widespread use, GAT has several limitations, including confounding related to corneal thickness, calibration errors, and concerns related to contamination and sanitation. [8][9][10][11] The non-contact ocular response analyser (ORA: Reichert Ophthalmic Instruments, Buffalo, NY, USA) provides a corneal compensated IOP measurement (IOPcc) that avoids several of the imitations of GAT. 7,8,10,[12][13][14][15] The ORA has received attention in the areas of glaucoma, corneal disorders, and refractive surgery.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of agreement between intraocular pressure measurements using Goldmann applanation tonometry and Goldmann correlated intraocular pressure by Reichert's ocular response analyser

Ehrlich

Haseltine

Shimmyo

et al. 2010

Eye

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Purpose To compare agreement of intraocular pressure (IOP) measurements using Goldmann applanation tonometry (GAT) and Goldmann correlated intraocular pressure generated (IOPg) by the Reichert ocular response analyser (ORA). Methods Consecutive patients presenting for glaucoma evaluation underwent ORA assessment followed by examination including GAT. For each ORA assessment, measurements were taken until a waveform score (WS) of 6.5 was obtained or until five measurements were obtained per eye. The relationship between GAT and IOPg and the influence of the WS upon this relationship was evaluated. A Bland-Altman plot and linear regression were used to determine agreement between GAT and IOPg. Results A total of 518 eyes of 260 patients were included in the final analysis. Increasing WS was found to predict a smaller difference between GAT and IOPg (b ¼ À0.2, Pp0.001). Selecting the highest WS among ORA assessments of each eye, WS continued to predict concordance between GAT and IOPg (b ¼ À0.2, P ¼ 0.006). The mean IOP difference between methods was 0.1 mm Hg (±0.3), which was found to be statistically insignificant (P ¼ 0.391). This relationship between GAT and IOPg was successfully validated using a second distinct data set of 100 eyes. GAT and IOPg measurements varied by 2 mm Hg or less in 53.9% of eyes and 5 mm Hg or less in 92.3% of eyes. Conclusion In clinical practice IOPg is strongly related to GAT. Although higher WS is indicative of greater IOPg/GAT concordance, its influence is minimal. This study does not support the use of a specific WS cutoff to determine quality of an IOPg measurement.

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“…Estudos realizados em adultos, demonstraram correlação positiva entre o aumento da espessura corneana central (ECC) e os valores obtidos com cada tonômetro (8)(9)(10) . Já no que diz respeito à curvatura corneana, sabemos que há associação positiva com a PIO (11) , em que o autor chegou à conclusão que a cada 3 dioptrias há aumento de 1 mmHg na PIO.…”

Section: Introductionunclassified

Espessura corneana central e suas correlações com outros dados biométricos oculares em pacientes portadores de glaucoma congênito

Mendes¹,

Sakata²,

Betinjane³

2011

Arq. Bras. Oftalmol.

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RESUMOObjetivo: Estudar a distribuição da espessura corneana central e suas correlações com outros dados biométricos em pacientes com glaucoma congênito. Métodos: Pacientes foram divididos em dois grupos, o A composto por portadores de glaucoma congênito, sendo este subdividido em subgrupos: com estrias de Haab (A1) e sem estrias de Haab (A2). O B representou o grupo controle. Resultados: O grupo A apresentou diâmetro corneano entre 11 e 15,5 mm, com média de 14,13 mm e desvio padrão de 1,28, enquanto o grupo B apresentou valores entre 11,5 e 12,5 mm, com média de 12,01 mm com desvio padrão de 0,09 (t=-8,9723 e p=1,5083 em nível 0,05). Os glaucomatosos apresentaram maiores valores médios de diâmetro axial (t=-6,46315, p=9,2498 em nível de significância de 0,05), e menores valores médios ceratométricos em relação aos controles. O subgrupo A1 apresentou espessura corneana central de 539 ± 46 μm, o subgrupo A2 apresentou média de 571 ± 56 μm e o grupo B de 559 ± 28 μm (t=0,43746 e p=0,66291). As correlações entre diâmetro corneano e axial foram positivas nos dois grupos. Já entre diâmetro corneano e ceratometria média foram negativas nos dois grupos. Conclusão: Os glaucomatosos apresentaram maior média de diâmetro axial e menor média ceratométrica em relação aos controles. Não houve diferença estatisticamente significativa da espessura corneana central. O diâmetro corneano se correlacionou positivamente como diâmetro axial e negativamente com a ceratometria média. Não se pode estabelecer correlações entre espessura corneana central e os demais dados biométricos. Descritores INTRODUÇÃOA perda visual em pacientes com glaucoma congênito (GC) ocorre na maioria dos pacientes de maneira precoce, não somente pelo dano do nervo óptico, mas também pelas alterações do bulbo ocular, particularmente as corneanas, como o edema ou então as roturas na membrana de Descemet (estrias de Haab) (1)(2) . O diagnóstico do GC é realizado através de uma semiologia bem conduzida, e quando realizado de maneira precoce muitas vezes impede a progressão da doença (3) . A tonometria é artifício semiológico de extrema importância para o diagnóstico, porém pode revelar valores errôneos devido às condições corneanas nestas crianças (4)(5)(6) , ou então pela variação relacionada à idade no mesmo paciente, como demonstrado na literatura (7) .Dentre os fatores que levam à interpretação errônea da pressão intraocular (PIO), figura a espessura corneana central como um dos principais. Estudos realizados em adultos, demonstraram correlação positiva entre o aumento da espessura corneana central (ECC) e os valores obtidos com cada tonômetro (8)(9)(10) . Já no que diz respeito à curvatura corneana, sabemos que há associação positiva com a PIO (11) , em que o autor chegou à conclusão que a cada 3 dioptrias há aumento de 1 mmHg na PIO.Dessa maneira, os valores da PIO nestas crianças, podem estar erroneamente aferidos com maior frequência do que em adultos, devido à possibilidade dos valores de espessura central e curvatura corneanas nestes pacientes estarem ...

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Ocular Response Analyzer versus Goldmann Applanation Tonometry for Intraocular Pressure Measurements

Abstract: The ORA significantly overestimates IOP compared with the GAT. Differences between both sets of measures increase as the GAT-determined IOP increases. ORA readings seem to be affected by central corneal thickness.

Cited by 124 publications

References 14 publications

Comparison of three methods of intraocular pressure measurement and their relation to central corneal thickness

Comparison of three methods of intraocular pressure measurement and their relation to central corneal thickness

Evaluation of agreement between intraocular pressure measurements using Goldmann applanation tonometry and Goldmann correlated intraocular pressure by Reichert's ocular response analyser

Espessura corneana central e suas correlações com outros dados biométricos oculares em pacientes portadores de glaucoma congênito

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