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      Performance of the PT100 noncontact tonometer in healthy eyes

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          Abstract

          Background:

          The purpose of this study was to assess the repeatability and reproducibility of the PT100 noncontact tonometer and to compare its consistency with the Goldmann applanation tonometer (GAT) in measuring intraocular pressure (IOP).

          Methods:

          Triplicate IOP measurements were obtained on two separate occasions using the PT100 and GAT from randomly selected eyes in 66 healthy volunteers aged 22 ± 1 years. The repeatability and reproducibility of each techniques was assessed. Agreement between the techniques was statistically quantified using intrasession repeatability for each technique as the basis for comparison.

          Results:

          Both techniques returned equal IOP values in the first measurement session (15 ± 3 mmHg). The second session showed a mean difference in average IOP (1 ± 0.71). The 95% limits of agreement between the techniques were −5.2 to 5.5 mmHg and −4.0 to 4.7 mmHg (sessions 1 and 2, respectively). These mean differences were not statistically significant ( P > 0.05, paired t-test), with the PT100 underestimating IOP measurement by 1.00 mmHg. The mean intrasession IOP for GAT sessions 1 and 2 was 0 ± 0.90 mmHg and 0.04 ± 1.06 mmHg, respectively, and the corresponding mean IOP measurement difference for the PT100 was −0.06 ± 0.96 and −0.39 ± 0.94 mmHg (sessions 1 and 2, respectively; P > 0.05, paired t-test). Repeatability coefficients for the GAT IOP measurements were 1.8 mmHg and 2.1 mmHg for sessions 1 and 2, while the PT100 repeatability coefficient was 1.9 mmHg and 1.8 mmHg for sessions 1 and 2, respectively. The intrasession repeatability coefficient of both techniques for test–retest differences were within ±5 mmHg.

          Conclusion:

          The PT100 noncontact tonometer produced greater repeatability than the GAT in assessment of IOP, whereas GAT resulted in more reproducible results. Both techniques showed a close level of agreement on comparison, with the PT100 underestimating IOP measurement by 1.0 mmHg only, although this was not clinically or statistically significant. Of importance is that the IOP measurements using these techniques could be interchangeable in the IOP range studied here.

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          Most cited references28

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          Statistical methods for assessing agreement between two methods of clinical measurement.

          In clinical measurement comparison of a new measurement technique with an established one is often needed to see whether they agree sufficiently for the new to replace the old. Such investigations are often analysed inappropriately, notably by using correlation coefficients. The use of correlation is misleading. An alternative approach, based on graphical techniques and simple calculations, is described, together with the relation between this analysis and the assessment of repeatability.
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            Measuring agreement in method comparison studies.

            Agreement between two methods of clinical measurement can be quantified using the differences between observations made using the two methods on the same subjects. The 95% limits of agreement, estimated by mean difference +/- 1.96 standard deviation of the differences, provide an interval within which 95% of differences between measurements by the two methods are expected to lie. We describe how graphical methods can be used to investigate the assumptions of the method and we also give confidence intervals. We extend the basic approach to data where there is a relationship between difference and magnitude, both with a simple logarithmic transformation approach and a new, more general, regression approach. We discuss the importance of the repeatability of each method separately and compare an estimate of this to the limits of agreement. We extend the limits of agreement approach to data with repeated measurements, proposing new estimates for equal numbers of replicates by each method on each subject, for unequal numbers of replicates, and for replicated data collected in pairs, where the underlying value of the quantity being measured is changing. Finally, we describe a nonparametric approach to comparing methods.
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              The Advanced Glaucoma Intervention Study (AGIS): 7. The relationship between control of intraocular pressure and visual field deterioration.The AGIS Investigators.

              (2000)
              To investigate the association between control of intraocular pressure after surgical intervention for glaucoma and visual field deterioration. In the Advanced Glaucoma Intervention Study, eyes were randomly assigned to one of two sequences of glaucoma surgery, one beginning with argon laser trabeculoplasty and the other trabeculectomy. In the present article we examine the relationship between intraocular pressure and progression of visual field damage over 6 or more years of follow-up. In the first analysis, designated Predictive Analysis, we categorize 738 eyes into three groups based on intraocular pressure determinations over the first three 6-month follow-up visits. In the second analysis, designated Associative Analysis, we categorize 586 eyes into four groups based on the percent of 6-month visits over the first 6 follow-up years in which eyes presented with intraocular pressure less than 18 mm Hg. The outcome measure in both analyses is change from baseline in follow-up visual field defect score (range, 0 to 20 units). In the Predictive Analysis, eyes with early average intraocular pressure greater than 17.5 mm Hg had an estimated worsening during subsequent follow-up that was 1 unit of visual field defect score greater than eyes with average intraocular pressure less than 14 mm Hg (P =.002). This amount of worsening was greater at 7 years (1.89 units; P <.001) than at 2 years (0.64 units; P =.071). In the Associative Analysis, eyes with 100% of visits with intraocular pressure less than 18 mm Hg over 6 years had mean changes from baseline in visual field defect score close to zero during follow-up, whereas eyes with less than 50% of visits with intraocular pressure less than 18 mm Hg had an estimated worsening over follow-up of 0.63 units of visual field defect score (P =.083). This amount of worsening was greater at 7 years (1.93 units; P <.001) than at 2 years (0.25 units; P =.572). In both analyses low intraocular pressure is associated with reduced progression of visual field defect, supporting evidence from earlier studies of a protective role for low intraocular pressure in visual field deterioration.
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                Author and article information

                Journal
                Clin Ophthalmol
                Clinical Ophthalmology
                Clinical Ophthalmology (Auckland, N.Z.)
                Dove Medical Press
                1177-5467
                1177-5483
                2011
                2011
                19 May 2011
                : 5
                : 661-666
                Affiliations
                Cornea Research Chair, Department of Optometry, College of Applied Medical Sciences, King Saud University, Riyadh, Kingdom of Saudi Arabia
                Author notes
                Correspondence: Turki M AlMubrad, Cornea Research Chair, Department of Optometry, College of Applied Medical Sciences, King Saud University, PO Box 10219, Riyadh 11433, Kingdom of Saudi Arabia, Tel +966 1469 3555, Fax +966 1469 3556, Email turkim@ 123456ksu.edu.sa
                Article
                opth-5-661
                10.2147/OPTH.S19885
                3104795
                21629572
                f0cc8159-b75c-498a-b37b-29cdb5d4f2fa
                © 2011 AlMubrad, publisher and licensee Dove Medical Press Ltd.

                This is an Open Access article which permits unrestricted noncommercial use, provided the original work is properly cited.

                History
                : 19 May 2011
                Categories
                Original Research

                Ophthalmology & Optometry
                goldmann applanation tonometer,noncontact tonometer,reichert pt100,intraocular pressure,reproducibility,repeatability

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