Abstract
Objectives
To evaluate the agreement between Goldmann applanation tonometry (GAT) and Ocular Response Analyser (ORA) intraocular pressure (IOP) measurements, and patients’ preferences.
Methods
Both eyes of participants in the ‘Glaucoma within the Northern Ireland Cohort for the Longitudinal Study of Ageing’ (GwNICOLA) were included. Participants underwent GAT by a glaucoma expert and ORA tonometry in a random order. Investigators were masked to measurements between devices. Participants were asked which tonometer, if any, they would prefer. We estimated the 95% limits of agreement (95% LoA) and the variables that influence agreement between tonometers.
Results
There were 228 eyes of 120 participants included in this study. Mean age of participants was 68.0 years (SD 8.79) and 52.5% were female. For GAT–ORA IOPcc the mean difference with GAT (95% CI) was −0.23 mmHg (−0.57 mmHg, 0.11 mmHg) and the 95% LoA (95% CIs) were from 4.82 mmHg (5.15 mmHg, 4.48 mmHg) to −5.28 mmHg (−5.61 mmHg, −4.94 mmHg). 40.8% of eyes had an IOP difference of 2 mmHg or more between GAT and ORA IOPcc. Corneal resistance factor (CRF) as estimated by ORA influenced the agreement between GAT and ORA IOPcc. There were no differences in preference for method of tonometry.
Conclusions
Although ORA IOPcc measurements with ORA did not show significant bias compared with GAT, the relatively large proportion of measurement differences between ORA IOPcc and GAT that were >2 mmHg indicates that GAT and ORA IOP measurements may not be interchangeable. There were no differences in preference for method of tonometry.
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Acknowledgements
We are grateful to all the participants of the NICOLA Study, and the whole NICOLA team, which includes nursing staff, research scientists, clerical staff, computer and laboratory technicians, managers and receptionists. The Atlantic Philanthropies, the Economic and Social Research Council, the UKCRC Centre of Excellence for Public Health Northern Ireland, the Centre for Ageing Research and Development in Ireland, the Office of the First Minister and Deputy First Minister, the Health and Social Care Research and Development Division of the Public Health Agency, the Wellcome Trust/Wolfson Foundation and Queen’s University Belfast provide core financial support for NICOLA. Belfast Association for the Blind provided core financial support for GwNICOLA. The authors alone are responsible for the interpretation of the data and any views or opinions presented are solely those of the authors and do not necessarily represent those of the NICOLA Study team. This material is original research, has not been previously published and has not been submitted for publication elsewhere while under consideration.
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McCann, P., Hogg, R.E., Wright, D.M. et al. Comparison of Goldmann applanation and Ocular Response Analyser tonometry: intraocular pressure agreement and patient preference. Eye 34, 584–590 (2020). https://doi.org/10.1038/s41433-019-0556-2
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DOI: https://doi.org/10.1038/s41433-019-0556-2
