July 2019
Volume 60, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2019
Postural Change in Intraocular Pressure and Agreement between Goldmann Applanation, Tonopen, and Perkins Tonometry
Author Affiliations & Notes
  • Kanza Aziz
    Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
  • Jing Fu
    Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
    Ophthalmology, Beijing Tongren Hospital, Beijing Tongren Eye Center, Capital Medical University, Beijing, China
  • Varshini Varadaraj
    Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
  • Alyssa Marie Kretz
    Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
  • Sayoko Moroi
    Kellogg Eye Center, University of Michigan, Ann Arbor, Michigan, United States
  • David S Friedman
    Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
  • Footnotes
    Commercial Relationships   Kanza Aziz, None; Jing Fu, None; Varshini Varadaraj, None; Alyssa Kretz, None; Sayoko Moroi, Bausch & Lomb (C); David Friedman, None
  • Footnotes
    Support  Icare Finland Oy
Investigative Ophthalmology & Visual Science July 2019, Vol.60, 2416. doi:https://doi.org/
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      Kanza Aziz, Jing Fu, Varshini Varadaraj, Alyssa Marie Kretz, Sayoko Moroi, David S Friedman; Postural Change in Intraocular Pressure and Agreement between Goldmann Applanation, Tonopen, and Perkins Tonometry. Invest. Ophthalmol. Vis. Sci. 2019;60(9):2416. doi: https://doi.org/.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To determine the variability in intraocular pressure (IOP) with postural change and evaluate the agreement between Goldmann Applanation, Tonopen, and Perkins Tonometry

Methods : Participants aged ≥ 22 years were recruited from two tertiary glaucoma clinics. Eyes with central corneal thickness <500µm or >600µm, prior incisional glaucoma or any corneal surgery, or any corneal pathology were excluded. One eye (higher IOP or randomly selected if same IOP in both eyes) per participant was tested. IOP was measured in the sitting position with the Goldmann Applanation Tonometer (GAT; Haag Streit). Participants were then placed in the supine position, after which supine IOP was measured by the Tonopen Avia (TP; Reichert) followed by the Perkins MK2 (Clement Clarke) tonometers. Each measurement was repeated twice, and a third measurement was taken if readings were >2mmHg apart; the mean or median IOP was used for analysis, respectively. Paired t-tests were used to test for statistical differences in measurements between tonometers. Bland-Altman plots were used to depict mean differences (MD) and 95% limits of agreement (LOA)

Results : Data from 118 eyes of 118 participants (56% female) were included in the analysis (we excluded one participant with three highly disparate measurements by TP). Mean ±SD GAT (sitting), Perkins (supine) and TP (supine) measurements were 17.0 ±5.2, 16.8 ±4.6 and 17.2 ±3.8 mmHg, respectively. The overall MD (LOA) between GAT (sitting) and Perkins (supine) [Fig.1], and Perkins and TP (both supine) [Fig.2] were 0.2 (-4.3 to 4.8), and -0.4 (-5.8 to 4.9), respectively. Bland-Altman plot showed higher IOP by Perkins (supine) when compared to GAT (sitting) at low IOP and lower by Perkins at high IOP [Fig.1]. There were no differences in overall IOP measurements in the sitting and supine positions (GAT vs. Perkins, p=0.25) as well as between tonometers in the supine position (Perkins vs. TP, p=0.08)

Conclusions : IOP overall was similar comparing sitting to supine, but supine measures were higher at lower IOP and lower at higher IOP. In the supine position, overall IOP measurements were similar between Perkins and Tonopen

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.

 

Figure 1. Bland-Altman Plot; GAT and Perkins

Figure 1. Bland-Altman Plot; GAT and Perkins

 

Figure 2. Bland-Altman Plot; Perkins and Tonopen

Figure 2. Bland-Altman Plot; Perkins and Tonopen

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