J Korean Ophthalmol Soc.  2017 Jun;58(6):685-691. 10.3341/jkos.2017.58.6.685.

Comparison of Intraocular Pressure via Goldmann-applanation Tonometry and TonoPen in Thyroid-associated Ophthalmopathy Accompanying Restrictive Strabismus

Affiliations
  • 1Department of Ophthalmology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea. opticdisc@gmail.com

Abstract

PURPOSE
To compare the intraocular pressure (IOP) measured using Goldmann-applanation tonometry (GAT) and Tonopen® tonometry and to evaluate the factors influencing the measurement difference in patients with thyroid-associated ophthalmopathy (TAO)-related restrictive strabismus.
METHODS
In 50 eyes of 50 patients who were diagnosed with TAO, IOP measurements were taken using both GAT and a Tonopen® and were subsequently compared between the devices. Factors influencing the measurement difference between the devices were determined, including the restriction of eyeball movement, eyeball deviation, exophthalmometry, central corneal thickness, refractive errors, and blood thyroid hormone levels.
RESULTS
In the TAO patients, the GAT-measured IOP was higher than for Tonopen® (16.1 ± 4.7 vs. 13.8 ± 4.5 mmHg, respectively, p < 0.001). As the restriction of vertical eyeball movement increased, the IOP difference between the devices also increased (p = 0.037). The absolute IOP difference between the devices was positively correlated with restrictions in vertical eyeball movement (p = 0.027), degree of vertical strabismus (p = 0.021), and central corneal thickness (p ≤ 0.031).
CONCLUSIONS
In patients with TAO accompanying vertical eyeball movement restriction, potential errors in IOP measurements should be considered between the different IOP-measuring devices.

Keyword

Goldmann-applanation tonometry; Intraocular pressure; Restrictive strabismus; Thyroid-associated ophthalmopathy; Tonopen®

MeSH Terms

Graves Ophthalmopathy*
Humans
Intraocular Pressure*
Manometry*
Refractive Errors
Strabismus*
Thyroid Gland
Troleandomycin
Troleandomycin

Reference

1. Kim M, Kim TW, Park KH, Kim JM. Risk factors for primary open-angle glaucoma in South Korea: the Namil study. Jpn J Ophthalmol. 2012; 56:324–329.
2. Kalmann R, Mourits MP. Prevalence and management of elevated intraocular pressure in patients with Graves' orbitopathy. Br J Ophthalmol. 1998; 82:754–757.
3. Fishman DR, Benes SC. Upgaze intraocular pressure changes and strabismus in Graves' ophthalmopathy. J Clin Neuroophthalmol. 1991; 11:162–165.
4. Ohtsuka K, Nakamura Y. Open-angle glaucoma associated with Graves disease. Am J Ophthalmol. 2000; 129:613–617.
5. Cockerham KP, Pal C, Jani B, et al. The prevalence and implications of ocular hypertension and glaucoma in thyroid-associated orbitopathy. Ophthalmology. 1997; 104:914–917.
6. Cook JA, Botello AP, Elders A, et al. Systematic review of the agreement of tonometers with Goldmann applanation tonometry. Ophthalmology. 2012; 119:1552–1557.
7. Wessels IF, Oh Y. Tonometer utilization, accuracy, and calibration under field conditions. Arch Ophthalmol. 1990; 108:1709–1712.
8. Iliev ME, Goldblum D, Katsoulis K, et al. Comparison of rebound tonometry with Goldmann applanation tonometry and correlation with central corneal thickness. Br J Ophthalmol. 2006; 90:833–835.
9. Zappia RJ, Winkelman JZ, Gay AJ. Intraocular pressure changes in normal subjects and the adhesive muscle syndrome. Am J Ophthalmol. 1971; 71:880–883.
10. Saunders RA, Helveston EM, Ellis FD. Differential intraocular pressure in strabismus diagnosis. Ophthalmology. 1981; 88:59–70.
11. Reader AL 3rd. Normal variations of intraocular pressure on vertical gaze. Ophthalmology. 1982; 89:1084–1087.
12. Nardi M, Bartolomei MP, Romani A, Barca L. Intraocular pressure changes in secondary positions of gaze in normal subjects and in restrictive ocular motility disorders. Graefes Arch Clin Exp Ophthalmol. 1988; 226:8–10.
13. Herzog D, Hoffmann R, Schmidtmann I, et al. Is gaze-dependent tonometry a useful tool in the differential diagnosis of Graves' ophthalmopathy? Graefes Arch Clin Exp Ophthalmol. 2008; 246:1737–1741.
14. Hessemer V, Rossler R, Jacobi KW. Tono-pen, a new position-independent tonometer. Comparison with the Goldmann tonometer by applanation measurement. Klin Monbl Augenheilkd. 1988; 193:420–426.
15. Kao SF, Lichter PR, Bergstrom TJ, et al. Clinical comparison of the Oculab Tono-Pen to the Goldmann applanation tonometer. Ophthalmology. 1987; 94:1541–1544.
16. Frenkel RE, Hong YJ, Shin DH. Comparison of the Tono-Pen to the Goldmann applanation tonometer. Arch Ophthalmol. 1988; 106:750–753.
17. Midelfart A, Wigers A. Clinical comparison of the ProTon and Tono-Pen tonometers with the Goldmann applanation tonometer. Br J Ophthalmol. 1994; 78:895–898.
18. Yilmaz I, Altan C, Aygit ED, et al. Comparison of three methods of tonometry in normal subjects: Goldmann applanation tonometer, non-contact airpuff tonometer, and Tono-Pen XL. Clin Ophthalmol. 2014; 8:1069–1074.
19. Anderson DR, Patella VM. Automated Static Perimetry. 2nd ed. St. Louis: Mosby;1999. p. 152–153.
20. Goldberg I. Thyroid eye disease and glaucoma. J Glaucoma. 2003; 12:494–496.
21. Manor RS, Kurz O, Lewitus Z. Intraocular pressure in endocrinological patients with exophthalmos. Ophthalmologica. 1974; 168:241–252.
22. Takahashi Y, Nakamura Y, Ichinose A, Kakizaki H. Intraocular pressure change with eye positions before and after orbital decompression for thyroid eye disease. Ophthal Plast Reconstr Surg. 2014; 30:47–50.
23. Rahman I, Cannon PS, Sadiq SA. Tonopen versus Goldmann applanation tonometry for detecting restrictive thyroid eye disease. Ophthal Plast Reconstr Surg. 2010; 26:36–38.
24. Boote C, Dennis S, Newton RH, et al. Collagen fibrils appear more closely packed in the prepupillary cornea: optical and biomechanical implications. Invest Ophthalmol Vis Sci. 2003; 44:2941–2948.
25. González-Méijome JM, Jorge J, Queirós A, et al. Age differences in central and peripheral intraocular pressure using a rebound tonometer. Br J Ophthalmol. 2006; 90:1495–1500.
26. Chui WS, Lam A, Chen D, Chiu R. The influence of corneal properties on rebound tonometry. Ophthalmology. 2008; 115:80–84.
27. Ehlers N, Bramsen T, Sperling S. Applanation tonometry and central corneal thickness. Acta Ophthalmol (Copenh). 1975; 53:34–43.
28. Argus WA. Ocular hypertension and central corneal thickness. Ophthalmology. 1995; 102:1810–1812.
29. Whitacre MM, Stein RA, Hassanein K. The effect of corneal thickness on applanation tonometry. Am J Ophthalmol. 1993; 115:592–596.
30. Herndon LW, Choudhri SA, Cox T, et al. Central corneal thickness in normal, glaucomatous, and ocular hypertensive eyes. Arch Ophthalmol. 1997; 115:1137–1141.
31. Wolfs RC, Klaver CC, Vingerling JR, et al. Distribution of central corneal thickness and its association with intraocular pressure: The Rotterdam Study. Am J Ophthalmol. 1997; 123:767–772.
32. Dohadwala AA, Munger R, Damji KF. Positive correlation between Tono-Pen intraocular pressure and central corneal thickness. Ophthalmology. 1998; 105:1849–1854.
33. Mok KH, Wong CS, Lee VW. Tono-Pen tonometer and corneal thickness. Eye (Lond). 1999; 13(Pt 1):35–37.
34. Tonnu PA, Ho T, Newson T, et al. The influence of central corneal thickness and age on intraocular pressure measured by pneumotonometry, non-contact tonometry, the Tono-Pen XL, and Goldmann applanation tonometry. Br J Ophthalmol. 2005; 89:851–854.
35. Bhan A, Browning AC, Shah S, et al. Effect of corneal thickness on intraocular pressure measurements with the pneumotonometer, Goldmann applanation tonometer, and Tono-Pen. Invest Ophthalmol Vis Sci. 2002; 43:1389–1392.
36. Kim NR, Kim CY, Kim H, et al. Comparison of goldmann applanation tonometer, noncontact tonometer, and TonoPen XL for intraocular pressure measurement in different types of glaucomatous, ocular hypertensive, and normal eyes. Curr Eye Res. 2011; 36:295–300.
37. Tonnu PA, Ho T, Sharma K, et al. A comparison of four methods of tonometry: method agreement and interobserver variability. Br J Ophthalmol. 2005; 89:847–850.
38. Schweier C, Hanson JV, Funk J, Töteberg-Harms M. Repeatability of intraocular pressure measurements with Icare PRO rebound, Tono-Pen AVIA, and Goldmann tonometers in sitting and reclining positions. BMC Ophthalmol. 2013; 13:44.
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