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A new rebound tonometer for home monitoring of intraocular pressure

  • Glaucoma
  • Published:
Graefe's Archive for Clinical and Experimental Ophthalmology Aims and scope Submit manuscript

Abstract

Background

To compare intraocular pressure (IOP) measurements obtained by the Icare ONE rebound tonometer (RTONE) and the Goldmann applanation tonometer (GAT) in healthy persons and glaucoma patients in a prospective study, and to investigate the influence of central corneal thickness (CCT).

Methods

Measurements on 126 right eyes were obtained by three equally skilled ophthalmologists with each of the above-mentioned tonometers. In addition, patients measured their own IOP with the RTONE (RTONE(p)). The means and standard deviation for all tonometers were compared. Agreement between the tonometers was calculated using the Bland–Altman method.

Results

A total of 95 (75.3%) patients were able to perform correct self-tonometry. Mean IOPs obtained were 17.1 ± 5.9 mmHg (RTONE performed by ophthalmologist: RTONE (o)), 17.3 ± 5.6 mmHg (RTONE(p)) and 16.5 ± 5.1 mmHg (GAT). Correlation analysis indicated a good correlation between IOP readings obtained using RTONE(o) and RTONE(p) (ρ = 0.916; p < 0.001) and RTONE(o) and GAT (ρ = 0.901; p < 0.001). Bland–Altman analysis revealed a mean difference (bias) between RTONE(o) and RTONE(p), between RTONE(o) and GAT, and between RTONE(p) and GAT of −0.2, 0.6, and 0.8 mmHg, respectively, with 95% limits of agreement of −5.0 to 4.5, –4.4 to 5.6, and −4.6 to 6.1 mmHg, respectively. The difference between RTONE(o) and GAT significantly increased with increasing CCT (ρ = 0.004), with a 10% increase in CCT resulting in a 1.8% increase in the difference.

Conclusions

Measurements obtained with the RTONE, either by an ophthalmologist or by the patient, showed an excellent correlation with those provided by applanation tonometry. RTONE generally tends to overestimate IOP compared to GAT readings and displays a dependence on CCT.

This study was registered with the DRKS (German Clinical Trials Register; www.germanctr.de; DRKS00000478).

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References

  1. Quigley HA (1996) Number of people with glaucoma worldwide. Br J Ophthalmol 80:389–393

    Article  PubMed  CAS  Google Scholar 

  2. Kass MA (1996) Standardizing the measurement of intraocular pressure for clinical research. Guidelines from the Eye Care Technology Forum. Ophthalmology 103:183–185

    PubMed  CAS  Google Scholar 

  3. Kontiola AI (1997) A new electromechanical method for measuring intraocular pressure. Doc Ophthalmol 93:265–276

    Article  CAS  Google Scholar 

  4. Danias J, Kontiola AI, Filippopoulos T, Mittag T (2003) Method for the noninvasive measurement of intraocular pressure in mice. Invest Ophthalmol Vis Sci 44:1138–1141

    Article  PubMed  Google Scholar 

  5. Abraham LM, Epasinghe NCR, Selva D, Casson R (2008) Comparison of the Icare® rebound tonometer with the Goldmann applanation tonometer by experienced and inexperience tonometrists. Eye 22:503–506

    Article  PubMed  CAS  Google Scholar 

  6. Sahin A, Basmak H, Niyaz L, Yildirim N (2007) Reproducibility and tolerability of the Icare rebound tonometer in school children. J Glaucoma 16:185–188

    Article  PubMed  Google Scholar 

  7. Martinez-de-la-Casa JM, Garcia-Feijoo J, Castillo A, Garcia-Sanchez J (2005) Reproducibility and clinical evaluation of rebound tonometry. Invest Ophthalmol Vis Sci 46:4578–4580

    Article  PubMed  Google Scholar 

  8. Dielemans I, Vingerling JR, Hofman A, Grobbee DE, de Jong PT (1994) Reliability of intraocular pressure measurement with the Goldmann applanation tonometer in epidemiological studies. Graefes Arch Clin Exp Ophthalmol 232:141–144

    Article  PubMed  CAS  Google Scholar 

  9. Bland JM, Altman DG (1986) Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1:307–310

    Article  PubMed  CAS  Google Scholar 

  10. van der Jagt LH, Jansonius LM (2005) Three portable tonometers, the TGDc-01, the Icare and the Tonopen XL, compared with each other and with Goldmann applanation tonometry. Ophthalmic Physiol Opt 25:429–435

    Article  PubMed  Google Scholar 

  11. Iliev ME, Goldblum D, Katsoulis K, Amstutz C, Frueh B (2006) Comparison of rebound tonometry with Goldmann applanation tonometry and correlation with central corneal thickness. Br J Ophthalmol 90:833–835

    Article  PubMed  CAS  Google Scholar 

  12. Fernandes P, Diaz-Rey JA, Queiros A, Gonzalez-Meijome JM, Jorge J (2005) Comparison of the Icare rebound tonometer with the Goldmann tonometer in a normal population. Ophthalmic Physiol Opt 25:436–440

    Article  PubMed  CAS  Google Scholar 

  13. Garcia-Resua C, Gonzalez-Meijome JM, Gilino J, Yebra-Pimentel E (2006) Accuracy of the new Icare rebound tonometer vs. other portable tonometers in healthy eyes. Optom Vis Sci 83:102–107

    Article  PubMed  Google Scholar 

  14. Martinez-de-la-Casa JM, Garcia-Feijoo J, Vico E, Fernandez-Vidal A, Benitez del Castillo JM, Wasfi M, Garcia-Sanchez J (2006) Effect of corneal thickness on dynamic contour, rebound, and Goldmann tonometry. Ophthalmology 113:2156–2162

    Article  PubMed  Google Scholar 

  15. Munkwitz S, Elkarmouty A, Hoffmann EM, Pfeiffer N, Thieme H (2008) Comparison of the Icare rebound tonometer and the Goldmann applanation tonometer over a wide IOP range. Graefes Arch Clin Exp Ophthalmol 246:875–879

    Article  PubMed  CAS  Google Scholar 

  16. Poostchi A, Mitchell R, Nicholas S, Purdie G, Wells A (2009) The Icare rebound tonometer: comparisons with Goldmann tonometry, and influence of central corneal thickness. Clin Exp Ophthalmol 37:687–691

    Article  Google Scholar 

  17. Emara B, Probst LE, Tingey DP, Kennedy DW, Willms LJ, Machat J (1998) Correlation of intraocular pressure and central corneal thickness in normal myopic eyes and after laser in situ keratomileusis. J Cataract Refract Surg 24:1320–1325

    PubMed  CAS  Google Scholar 

  18. Lam AK, Wu R, Wang Z, Woo V, Chan E, Tam K, Chau R, Wong KK (2010) Effect of laser in situ keratomileusis on rebound tonometry and Goldmann applanation tonometry. J Cataract Refract Surg 36:631–636

    Article  PubMed  Google Scholar 

  19. Schipper I, Senn P, Oyo-Szerenyi K, Peter R (2000) Central and peripheral pressure measurements with the Goldmann tonometer and Tono-Pen after photorefractive keratectomy for myopia. J Cataract Refract Surg 26:929–933

    Article  PubMed  CAS  Google Scholar 

  20. Ehlers N, Bramsen T, Sperling S (1975) Applanation tonometry and central corneal thickness. Acta Ophthalmol 53:34–43

    CAS  Google Scholar 

  21. Kohlhaas M, Boehm AG, Spoerl E, Pürsten A, Grein HJ, Pillunat LE (2006) Effect of central corneal thickness, corneal curvature, and axial length on applanation tonometry. Arch Ophthalmol 124:471–476

    Article  PubMed  Google Scholar 

  22. Whitacre MM, Stein RA, Hassanein K (1993) The effect of corneal thickness on applanation tonometry. Am J Ophthalmol 115:592–596

    PubMed  CAS  Google Scholar 

  23. Martinez-de-la-Casa JM, Garcia-Feijoo J, Saenz-Frances VG, Fernandez-Vidal A, Mendez-Hernandez C, Garcia-Sanchez J (2009) Comparison of rebound tonometer and Goldmann handheld applanation tonometer in congenital glaucoma. J Glaucoma 18:49–52

    Article  PubMed  Google Scholar 

  24. Pakrou N, Gray T, Mills R, Landers J, Craig J (2008) Clinical comparison of the Icare tonometer and Goldmann applanation tonometry. J Glaucoma 17:43–47

    Article  PubMed  Google Scholar 

  25. Brusini P, Salvetat ML, Zeppieri M, Tosoni C, Parisi L (2006) Comparison of Icare tonometer with Goldmann applanation tonometer in glaucoma patients. J Glaucoma 15:213–217

    Article  PubMed  Google Scholar 

  26. Sacu S, Vass C, Schemper M, Rainer G (2004) Self-tonometry with the Ocuton S: evaluation of accuracy in glaucoma patients. Acta Ophthalmol Scand 82:405–409

    Article  PubMed  Google Scholar 

  27. Leonardi M, Leuenberger P, Bertrand D, Bertsch A, Renaud P (2004) First steps toward noninvasive intraocular pressure monitoring with a sensing contact lens. Invest Ophthalmol Vis Sci 45:3113–3117

    Article  PubMed  Google Scholar 

  28. Leonardi M, Pitchon EM, Bertsch A, Renaud P, Mermoud A (2009) Wireless contact lens sensor for intraocular pressure monitoring: assessment on enucleated pig eyes. Acta Ophthalmol 87:433–437

    Article  PubMed  Google Scholar 

  29. Hediger A, Kniestedt C, Zweifel S, Knecht P, Funk J, Kanngiesser H (2009) Continuous intraocular pressure measurement: first results with a pressure-sensitive contact lens. Ophthalmologe 106:1111–1115

    Article  PubMed  CAS  Google Scholar 

  30. Draeger J, Schwartz R, Deutsch C, Groenhoff S (1991) Clinical and experimental results with a new fully automatic self-tonometer. Fortschr Ophthalmol 88:304–307

    PubMed  CAS  Google Scholar 

  31. Draeger J, Groenhoff S, Hock B, Klemm M (1993) Optimizing the automatic self-tonometer by an acoustic control signal and changed fixation optics. Ophthalmologe 90:54–57

    PubMed  CAS  Google Scholar 

  32. Asrani S, Chatterjee A, Wallace DK, Santiago-Turla C, Stinnett S (2011) Evaluation of the Icare rebound tonometer as a home intraocular pressure monitoring device. J Glaucoma 20:74–79

    Article  PubMed  Google Scholar 

  33. Chui WS, Lam A, Chen D, Chiu R (2008) The influence of corneal properties on rebound tonometry. Ophthalmology 115:80–84

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Ophthalmology, University of Cologne, Joseph-Stelzmann-Str. 9, 50931, Cologne, Germany

    André Rosentreter, Kerstin S. Jablonski, Anne C. Mellein, Stergiani Gaki, Arno Hueber & Thomas S. Dietlein

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  1. André Rosentreter
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  2. Kerstin S. Jablonski
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  3. Anne C. Mellein
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  4. Stergiani Gaki
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  5. Arno Hueber
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  6. Thomas S. Dietlein
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Corresponding author

Correspondence to André Rosentreter.

Additional information

The authors have full control of all primary data and agree to allow Graefes Archive for Clinical and Experimental Ophthalmology to review their data upon request.

Clinical trial registration: German Clinical Trials Register; number: DRKS00000478.

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Rosentreter, A., Jablonski, K.S., Mellein, A.C. et al. A new rebound tonometer for home monitoring of intraocular pressure. Graefes Arch Clin Exp Ophthalmol 249, 1713–1719 (2011). https://doi.org/10.1007/s00417-011-1785-7

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  • DOI: https://doi.org/10.1007/s00417-011-1785-7

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