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Intraocular pressure determination in infants with severe retinopathy of prematurity
M E Hartnett1, T Hirose, T M Richardson
1Eye Research Institute, Boston, Massachusetts.
Insights
Measuring intraocular pressure (IOP) in premature infants with retinopathy of prematurity (ROP) is crucial. Applanation tonometry is recommended over indentation tonometry due to fewer technical errors and less influence from scleral rigidity.
Area of Science:
- Ophthalmology
- Neonatology
- Pediatric Medicine
Background:
- Retinopathy of prematurity (ROP) is a significant cause of vision impairment in premature infants.
- Accurate intraocular pressure (IOP) measurement is vital for managing ROP, particularly after surgical interventions.
- Scleral rigidity in premature infants is variable and can affect IOP readings.
Purpose of the Study:
- To compare applanation and indentation tonometry for IOP measurement in premature infants with stage V ROP.
- To identify factors influencing the accuracy of IOP readings in this population.
- To recommend the preferred tonometry method for infants with ROP.
Main Methods:
- Intraocular pressure (IOP) was measured in 55 premature infants (122 determinations) with stage V ROP.
- Both applanation and indentation tonometry were used, with corrections for scleral rigidity.
- Correlation between the two methods was analyzed, along with the influence of chronologic age and scleral rigidity coefficient.
Main Results:
- A modest correlation (r = 0.52) was found between applanation and indentation tonometry readings.
- Chronologic age and scleral rigidity coefficient were the most significant factors affecting the agreement between IOP measurements.
- Applanation tonometry showed less susceptibility to technical error and scleral variability.
Conclusions:
- Applanation tonometry is the preferable method for measuring IOP in infants with ROP.
- Frequent IOP monitoring is recommended to detect early increases, especially post-vitreoretinal surgery.
- Understanding factors affecting IOP readings is crucial for accurate diagnosis and management in ROP patients.
Abstract:
We determined intraocular pressure (IOP) in 55 premature infants (122 determinations) with stage V retinopathy of prematurity (ROP) by applanation and indentation tonometry corrected for scleral rigidity and found a modest correlation of r = 0.52 between readings. Chronologic age and the scleral rigidity coefficient were the most significant factors affecting the closeness in readings. Our findings suggest that the applanation method of obtaining IOP values is preferable in infants with ROP because this method is less affected by technical error and the variable nature of premature infant sclera. Frequent examination may be necessary to detect an early IOP increase, especially in infants who have had successful retinal reattachment through vitreoretinal techniques.