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Ocular Response Analyzer versus Goldmann Applanation Tonometry in a Population-based Sample: The Thessaloniki Eye
Rodanthi Christina Bartzoulianou1, Anne L Coleman2, M Roy Wilson3
1st Department of Ophthalmology, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece; Laboratory of Research and Clinical Applications in Ophthalmology, Aristotle University of Thessaloniki, Thessaloniki, Greece.
Corneal-compensated intraocular pressure (IOPcc) is not interchangeable with Goldmann applanation tonometry (GAT-IOP) in elderly individuals. Using IOPcc may overestimate ocular hypertension and alter glaucoma risk assessments.
Area of Science:
- Ophthalmology
- Glaucoma Research
- Diagnostic Accuracy
Background:
- Intraocular pressure (IOP) measurement is crucial for glaucoma diagnosis and management.
- Goldmann applanation tonometry (GAT-IOP) is the standard, but corneal properties can affect its accuracy.
- Corneal-compensated IOP (IOPcc) aims to correct for corneal biomechanical effects.
Purpose of the Study:
- To compare IOPcc with GAT-IOP in an elderly cohort.
- To evaluate the impact of substituting GAT-IOP with IOPcc on IOP distribution, ocular hypertension prevalence, glaucoma screening, and risk modeling.
Main Methods:
- Prospective diagnostic analysis of population-based data from 854 elderly participants (Thessaloniki Eye Study).
- Measurement of both GAT-IOP and IOPcc in one eye per participant.
- Assessment of agreement, sensitivity, specificity, and AUC; construction of two multivariable logistic regression models (one with GAT-IOP, one with IOPcc).
Main Results:
- IOPcc (17.1 mmHg) was consistently higher than GAT-IOP (14.3 mmHg) in the elderly cohort.
- Ocular hypertension prevalence increased significantly from 1.3% to 10.7% when using IOPcc thresholds.
- GAT-IOP was associated with central corneal thickness (CCT), while IOPcc was not; IOPcc showed higher sensitivity but lower specificity for glaucoma screening compared to GAT-IOP.
Conclusions:
- IOPcc and GAT-IOP are not interchangeable in elderly populations.
- Standard IOPcc thresholds may lead to an overestimation of ocular hypertension.
- Substitution of GAT-IOP with IOPcc alters glaucoma risk estimates and the significance of factors like CCT and axial length in risk models.
