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Related Experiment Video

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Determining Significant Elevation of Intraocular Pressure Using Self-tonometry.

Jessie Huang1, Jack Phu1, Michael Kalloniatis1

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Optometry and Vision Science : Official Publication of the American Academy of Optometry
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Summary

Icare HOME rebound tonometry, used for glaucoma monitoring, can be challenging to interpret. A new tool, Threshold Icare HOME IOP, helps clinicians understand measurements compared to applanation tonometry, aiding glaucoma management.

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Area of Science:

  • Ophthalmology
  • Glaucoma Management
  • Ophthalmic Devices

Background:

  • Icare HOME rebound tonometry is increasingly used for intraocular pressure (IOP) phasing in glaucoma patients.
  • Interpreting Icare HOME IOP measurements can be challenging due to differences with applanation tonometry and diurnal fluctuations.

Purpose of the Study:

  • To develop a practical analytical tool for interpreting Icare HOME IOP measurements.
  • To compare Icare HOME measurements against applanation tonometry in a large patient cohort.

Main Methods:

  • Prospective IOP measurements using Icare HOME and applanation tonometry in 498 patients.
  • Statistical analysis including Bland-Altman, frequency distribution, and linear regression.
  • Development of a novel criterion, Threshold Icare HOME IOP, for elevated pressure identification.

Main Results:

  • Icare HOME tended to underestimate applanation tonometry (mean bias -1.7 mmHg).
  • 71.5% of differences were within ±3 mmHg, and 92% within ±5 mmHg.
  • Measurements exceeding target applanation pressure by ≥6 mmHg were generally outside expected limits.

Conclusions:

  • The Threshold Icare HOME IOP is a practical criterion for interpreting Icare HOME measurements.
  • This tool assists in identifying elevated IOP relative to target applanation pressures.
  • Elevated readings may necessitate closer patient monitoring or treatment adjustments for glaucoma.