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Article: Pressure phosphene self-tonometry: A comparison with Goldmann tonometry in glaucoma patients

TitlePressure phosphene self-tonometry: A comparison with Goldmann tonometry in glaucoma patients
Authors
Issue Date2004
PublisherAssociation for Research in Vision and Ophthalmology. The Journal's web site is located at http://www.iovs.org
Citation
Investigative Ophthalmology And Visual Science, 2004, v. 45 n. 9, p. 3131-3136 How to Cite?
AbstractPURPOSE. To evaluate whether the pressure phosphene tonometer (PPT) is suitable for self-tonometry in patients with glaucoma or ocular hypertension. METHODS. This was a prospective comparative study of 102 eyes of 102 patients with chronic glaucoma or ocular hypertension. Intraocular pressure (IOP) measurements by the Goldmann tonometer (GT) were compared with self-measured readings with the PPT. Patients evaluated the ease of home use of the PPT. The last 15 patients were asked to stop their glaucoma medications, and the ability of the PPT to detect an elevated IOP during self-tonometry was studied. RESULTS. The mean ± SD difference between PPT and GT readings was -0.24 ± 1.57 mm Hg. Comparing the PPT with the GT, 86% of the readings were within ± 2.0 mm Hg, and 91% were within ± 3.0 mm Hg. Spearman's correlation coefficient was 0.91. A Bland-Altman plot showed that the 95% limits of agreement between the two methods lay between 2.90 and -3.38 mm Hg. Within-subject coefficients of variation for the GT and the PPT were 4.4% and 7.3%, respectively. In detecting an elevated IOP of more than 21 mm Hg, the sensitivity and the specificity of the PPT were 92.3% and 98.6% respectively. The mean satisfaction score for home use of the PPT was 87.4 ± 16.3 (maximum 100). CONCLUSIONS. With proper training and technique, self-tonometry with the PPT appears to be accurate up to at least 25 mm Hg and is reproducible. The PPT was sensitive and specific in detecting an elevated IOP of more than 21 mm Hg. As patients were expected to seek ophthalmic care before the self-measured IOP reaches 25 mm Hg, the PPT may have a value for self-monitoring. Patients rated the PPT as satisfactory for home use. Because the PPT is portable and relatively inexpensive and requires no topical anesthesia or direct contact with the eyeball, it may have potential as an instrument for home self-tonometry.
Persistent Identifierhttp://hdl.handle.net/10722/176472
ISSN
2015 Impact Factor: 3.427
2015 SCImago Journal Rankings: 2.008
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorLam, DSCen_US
dc.contributor.authorLeung, DYLen_US
dc.contributor.authorChiu, TYHen_US
dc.contributor.authorFan, DSPen_US
dc.contributor.authorCheung, EYYen_US
dc.contributor.authorWong, TYen_US
dc.contributor.authorLai, JSMen_US
dc.contributor.authorTham, CCYen_US
dc.date.accessioned2012-11-26T09:11:39Z-
dc.date.available2012-11-26T09:11:39Z-
dc.date.issued2004en_US
dc.identifier.citationInvestigative Ophthalmology And Visual Science, 2004, v. 45 n. 9, p. 3131-3136en_US
dc.identifier.issn0146-0404en_US
dc.identifier.urihttp://hdl.handle.net/10722/176472-
dc.description.abstractPURPOSE. To evaluate whether the pressure phosphene tonometer (PPT) is suitable for self-tonometry in patients with glaucoma or ocular hypertension. METHODS. This was a prospective comparative study of 102 eyes of 102 patients with chronic glaucoma or ocular hypertension. Intraocular pressure (IOP) measurements by the Goldmann tonometer (GT) were compared with self-measured readings with the PPT. Patients evaluated the ease of home use of the PPT. The last 15 patients were asked to stop their glaucoma medications, and the ability of the PPT to detect an elevated IOP during self-tonometry was studied. RESULTS. The mean ± SD difference between PPT and GT readings was -0.24 ± 1.57 mm Hg. Comparing the PPT with the GT, 86% of the readings were within ± 2.0 mm Hg, and 91% were within ± 3.0 mm Hg. Spearman's correlation coefficient was 0.91. A Bland-Altman plot showed that the 95% limits of agreement between the two methods lay between 2.90 and -3.38 mm Hg. Within-subject coefficients of variation for the GT and the PPT were 4.4% and 7.3%, respectively. In detecting an elevated IOP of more than 21 mm Hg, the sensitivity and the specificity of the PPT were 92.3% and 98.6% respectively. The mean satisfaction score for home use of the PPT was 87.4 ± 16.3 (maximum 100). CONCLUSIONS. With proper training and technique, self-tonometry with the PPT appears to be accurate up to at least 25 mm Hg and is reproducible. The PPT was sensitive and specific in detecting an elevated IOP of more than 21 mm Hg. As patients were expected to seek ophthalmic care before the self-measured IOP reaches 25 mm Hg, the PPT may have a value for self-monitoring. Patients rated the PPT as satisfactory for home use. Because the PPT is portable and relatively inexpensive and requires no topical anesthesia or direct contact with the eyeball, it may have potential as an instrument for home self-tonometry.en_US
dc.languageengen_US
dc.publisherAssociation for Research in Vision and Ophthalmology. The Journal's web site is located at http://www.iovs.orgen_US
dc.relation.ispartofInvestigative Ophthalmology and Visual Scienceen_US
dc.subject.meshAdulten_US
dc.subject.meshAgeden_US
dc.subject.meshChronic Diseaseen_US
dc.subject.meshGlaucoma - Diagnosis - Physiopathologyen_US
dc.subject.meshHumansen_US
dc.subject.meshIntraocular Pressureen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshOcular Hypertension - Diagnosis - Physiopathologyen_US
dc.subject.meshPatient Satisfactionen_US
dc.subject.meshPhosphenesen_US
dc.subject.meshProspective Studiesen_US
dc.subject.meshReproducibility Of Resultsen_US
dc.subject.meshSelf Careen_US
dc.subject.meshSensitivity And Specificityen_US
dc.subject.meshTonometry, Ocular - Methodsen_US
dc.titlePressure phosphene self-tonometry: A comparison with Goldmann tonometry in glaucoma patientsen_US
dc.typeArticleen_US
dc.identifier.emailLai, JSM: laism@hku.hken_US
dc.identifier.authorityLai, JSM=rp00295en_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.1167/iovs.04-0115en_US
dc.identifier.pmid15326131-
dc.identifier.scopuseid_2-s2.0-4344606732en_US
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-4344606732&selection=ref&src=s&origin=recordpageen_US
dc.identifier.volume45en_US
dc.identifier.issue9en_US
dc.identifier.spage3131en_US
dc.identifier.epage3136en_US
dc.identifier.isiWOS:000223500900036-
dc.publisher.placeUnited Statesen_US
dc.identifier.scopusauthoridLam, DSC=35500200200en_US
dc.identifier.scopusauthoridLeung, DYL=13309931100en_US
dc.identifier.scopusauthoridChiu, TYH=7202210389en_US
dc.identifier.scopusauthoridFan, DSP=7202965663en_US
dc.identifier.scopusauthoridCheung, EYY=7006522431en_US
dc.identifier.scopusauthoridWong, TY=35231271400en_US
dc.identifier.scopusauthoridLai, JSM=7401939748en_US
dc.identifier.scopusauthoridTham, CCY=7006081241en_US

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