June 2023
Volume 64, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2023
Properties associated with intraocular pressure dissonance as measured by Goldman Applanation Tonometry compared to the Ocular Response Analyzer
Author Affiliations & Notes
  • Matthew C. Johnson
    Massachusetts Eye and Ear Department of Ophthalmology, Boston, Massachusetts, United States
    Harvard Medical School, Boston, Massachusetts, United States
  • Joyce Kang
    Massachusetts Eye and Ear Department of Ophthalmology, Boston, Massachusetts, United States
  • Yan Zhao
    Massachusetts Eye and Ear Department of Ophthalmology, Boston, Massachusetts, United States
  • Michael M Lin
    Massachusetts Eye and Ear Department of Ophthalmology, Boston, Massachusetts, United States
    Harvard Medical School, Boston, Massachusetts, United States
  • David S. Friedman
    Massachusetts Eye and Ear Department of Ophthalmology, Boston, Massachusetts, United States
    Harvard Medical School, Boston, Massachusetts, United States
  • Footnotes
    Commercial Relationships   Matthew Johnson None; Joyce Kang None; Yan Zhao None; Michael Lin None; David Friedman None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2023, Vol.64, 1384. doi:
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      Matthew C. Johnson, Joyce Kang, Yan Zhao, Michael M Lin, David S. Friedman; Properties associated with intraocular pressure dissonance as measured by Goldman Applanation Tonometry compared to the Ocular Response Analyzer. Invest. Ophthalmol. Vis. Sci. 2023;64(8):1384.

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

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Abstract

Purpose : Intraocular pressure (IOP) measurement is crucial for glaucoma management. “Corneal-compensated” IOP (IOPcc), as measured by the Ocular Response Analyzer (ORA), is more predictive of glaucoma progression than IOP measured by Goldmann applanation tonometry (GAT), and the characteristics that drive inter-device disagreement are not fully understood. We performed a prospective case-control clinical study to understand the ocular and demographic characteristics associated with substantial inter-device IOP disagreement.

Methods : Patients with diagnoses of ocular hypertension, suspected glaucoma, or glaucoma who had central corneal thickness (CCT) between 500 to 600 µm underwent IOP measurements with the ORA and GAT. Eighty-five eyes of eighty-five patients with large (≥4.0 mm Hg) or small (≤2.0 mm Hg) IOP dissonance were enrolled as cases and controls, respectively, and underwent biometry measurement. Univariate regression analysis was performed to evaluate associations between high inter-device IOP dissonance and age, sex, eye laterality, average corneal curvature, average IOP, anterior chamber depth, axial length, CCT, lens status, and corneal hysteresis.

Results : Fifty-four case and thirty-one control eyes were enrolled from patients with a mean age of 67.1 ± 11.4 years. Among the large IOP dissonance group, the ORA reported higher IOP than GAT in 83% of cases. Low corneal hysteresis was significantly associated with device disagreement (OR=0.48 per mm Hg, p<0.001), and pseudophakic lens status (OR 1.69, p=0.26) and anterior chamber depth (OR=1.3 per mm, p=0.30) were found to have an OR of 1.3 or greater. CCT and average IOP did not influence device agreement (Table 1).

Conclusions : These preliminary results indicate that when there is high inter-device IOP disagreement between GAT and ORA, ORA frequently reports higher IOP values. Corneal hysteresis is strongly associated with device disagreement despite using IOPcc, and aspects of anterior chamber anatomy may influence this relationship as well.

This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.

 

Table 1. Association between high intraocular pressure (IOP) dissonance, as measured by Goldmann Applanation Tonometry (GAT) compared to the Ocular Response Analyzer (ORA), and other variables using univariate logistic regression analysis

Table 1. Association between high intraocular pressure (IOP) dissonance, as measured by Goldmann Applanation Tonometry (GAT) compared to the Ocular Response Analyzer (ORA), and other variables using univariate logistic regression analysis

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