[Comparison of optic nerve head measurements obtained with the slit lamp and with CSLO]. / Comparación de las medidas de la papila obtenidas con biomicroscopia y con oftalmoscopia de láser confocal.

PURPOSE: To evaluate the accuracy of disk size and cup/disk ratio (C/D) estimation by measuring the vertical diameter and cup/disk ratio at the slit lamp. METHODS: Two hundred and thirty eight eyes of 185 people, 82 glaucomas and 156 normal subjects were included. All underwent slit lamp examination, tonometry, optic nerve photographs, scanning laser tomography (HRT) and standard perimetry (Humphrey). Correlation between slit lamp measurements (vertical diameter and C/D ratio) and HRT parameters was evaluated. RESULTS: There is a significant correlation between the disk diameter measured at the slit lamp and the disk area measured with HRT (Pearson Test, r: 0.52, p<0.001). Additionally, there is significant correlation between the semi-quantitative estimation of C/D ratio at the slit lamp and the C/D area ratio from the HRT (r: 0.83, p<0.001). CONCLUSION: Measuring the vertical diameter and the C/D ratio at the slit lamp is a useful method for estimating the real disk area and C/D ratio. It is highly recommended that disk size be estimated when attempting to interpret clinical findings in the optic nerve head.

Comparación de las medidas de la papila obtenidas con biomicroscopia y con oftalmoscopia de láser confoncal / Comparison of Optic Nerve Head Mesurements Obtained with the Slit Lamp and with CSLO

Objetivo: Evaluar la precisión de la estimación del tamaño de la papila y el índice excavación/papila (E/P) mediante la medición del diámetro vertical y la excavación en la lámpara de hendidura. Método: Se incluyeron 238 ojos de 185 personas, 82 con glaucoma y 156 normales. Todos fueron examinados con lámpara de hendidura, tonometría, fotografías del nervio óptico, tomografía con láser confocal (HRT) y perimetría estándar (Humphrey). Se evaluó la correlación entre el diámetro vertical de la papila y el índice excavación/papila (E/P) medidos en la lámpara de hendidura (lente de 90 o 78 dioptrías) y varios parámetros objetivos obtenidos con el HRT. Resultados: Existe una correlación estadísticamente significativa entre el diámetro papilar estimado mediante biomicroscopía y el área de la papila calculado por el HRT (Test de Pearson, r: 0,52, p<0,001). Asimismo se observó una correlación estadísticamente significativa entre la estimación semicuantitativa del índice E/P obtenido por biomicroscopia y el parámetro área de la excavación/área de la papila calculado por el HRT (r: 0,83; p<0,001). Conclusión: La medida del diámetro vertical y del índice E/P en la lámpara de hendidura es una buena estimación del área de la papila y del cociente área excavación/área de la papila. Se recomienda la valoración del tamaño de la papila a la hora de interpretar los hallazgos clínicos observados en el nervio óptico(AU)

Purpose: To evaluate the accuracy of disk size and cup/disk ratio (C/D) estimation by measuring the vertical diameter and cup/disk ratio at the slit lamp. Methods: Two hundred and thirty eight eyes of 185 people, 82 glaucomas and 156 normal subjects were included. All underwent slit lamp examination, tonometry, optic nerve photographs, scanning laser tomography (HRT) and standard perimetry (Humphrey). Correlation between slit lamp measurements (vertical diameter and C/D ratio) and HRT parameters was evaluated. Results: There is a significant correlation between the disk diameter measured at the slit lamp and the disk area measured with HRT (Pearson Test, r: 0.52, p<0.001). Additionally, there is significant correlation between the semi-quantitative estimation of C/D ratio at the slit lamp and the C/D area ratio from the HRT (r: 0.83, p<0.001). Conclusion: Measuring the vertical diameter and the C/D ratio at the slit lamp is a useful method for estimating the real disk area and C/D ratio. It is highly recommended that disk size be estimated when attempting to interpret clinical findings in the optic nerve head(AU)

[Comparative study of two portable tonometers: Tono-Pen XL and Perkins]. / Estudio comparativo de dos tonómetros portátiles: Tono-Pen XL y Perkins.

PURPOSE: To evaluate the reproducibility of two portable tonometers and to compare the intraocular pressure (IOP) measurements obtained with both instruments taking into account the level of experience of the examiner with this technique. METHOD: Cross-sectional study. IOP was measured in 35 eyes of 35 normal subjects and 20 eyes of 20 ocular hypertensive patients with Perkins aplanation tonometer and Tono-Pen XL digital tonometer. Five measurements were made with Perkins (by an ophthalmologist) and 10 with Tono-Pen (5 by an ophthalmologist and 5 by a general practitioner). RESULTS: Considering the sample as a whole there was no statistically significant difference, and there was a significant correlation between the mean measurements obtained with Perkins tonometer and Tono-Pen and between the mean obtained by doctors with and without previous tonometric experience (p<0.001, ANOVA). Variability of Tono-Pen measurements is greater than the Perkins measurements and it is considerable in both cases (coefficient of variation 7-9%). Tono-Pen measurements tend to show a greater variability in hypertensive subjects, and tend to underestimate high IOP when compared with Perkins measurements. Tono-Pen identified IOP > or =21 mmHg with a sensitivity of 40% and a specificity of 94-97%. CONCLUSION: Tono-Pen allows measurement of IOP to personal with no tonometric experience. There is a strong correlation between measurements obtained with both tonometers. Tono-Pen shows a tendency to underestimate high IOP and offers low sensitivity in detecting IOP greater than 21 mmHg.

Estudio comparativo de dos tonómetros portátiles: Tono-Pen XL y Perkins / Comparative study of two portable tonometers: Tono-Pen XL and Perkins

Objetivo: Valorar la reproducibilidad de dos tonómetros portátiles y comparar las medidas de presión intraocular (PIO) obtenidas con ambos instrumentos y por facultativos con y sin formación tonométrica previa. Método: Estudio transversal. Se midió la PIO de 35 ojos de 35 sujetos normales y de 20 ojos de 20 sujetos hipertensos oculares con el tonómetro de aplanación Perkins y el tonómetro digital Tono-Pen XL. Se realizaron 5 medidas con Perkins (oftalmólogo) y 10 con Tono-Pen (5 por el oftalmólogo y 5 por el médico general).Resultados: Considerando las medidas medias y todos los sujet os en conjunto no se observaron diferencias significativas, y sí una correlación estadísticamente significativa entre las medidas medias obtenidas con ambos tonómetros y entre facultativos (p<0,001, ANOVA). La variabilidad de las medidas realizadas con el Tono-Pen es mayor que la conseguida con el Perkins y en ambos casos es considerable (coeficiente de variación 7 por ciento a 9 por ciento). En los hipertensos oculares existe una tendencia a una mayor variabilidad de las medidas realizadas con el Tono-Pen, así como a una infravaloración de las PIO elevadas al compararlas con el Perkins. El Tono-Pen identificó PIO = 21 mmHg con una sensibilidad del 40 por ciento y una especificidad del 94-97 por ciento. Conclusión: El Tono-Pen permite medir la PIO a facultativos sin experiencia tonométrica previa. Se observó una elevada correlación entre las medidas realizadas con ambos tonómetros y por cada facultativo. El Tono-Pen presenta una tendencia a infravalorar las PIO elevadas y una baja sensibilidad para detectar PIO superiores a 21 mmHg (AU)

Purpose: To evaluate the reproducibility of two portable tonometers and to compare the intraocular pressure (IOP) measurements obtained with both instruments taking into account the level of experience of the examiner with this technique. Method: Cross-sectional study. IOP was measured in 35 eyes of 35 normal subjects and 20 eyes of 20 ocular hypertensive patients with Perkins aplanation tonometer and Tono-Pen XL digital tonometer. Five measurements were made with Perkins (by an ophthalmologist) and 10 with Tono-Pen (5 by an ophthalmologist and 5 by an general practitioner). Results: Considering the sample as a whole there was no statistically significant difference, and there was a significant correlation between the mean measurements obtained with Perkins tonometer and Tono-Pen and between the mean obtained by doctors with and without previous tonometric experience (p< 0.001, ANOVA). Variability of Tono-Pen measurements is greater than the Perkins measurements and it is considerable in both cases (coefficient of variation 7-9%). Tono-Pen measurements tend to show a greater variability in hypertensive subjects, and tend to underestimate high IOP when compared with Perkins measurements. Tono-Pen identified IOP ≥ 21 mmHg with a sensitivity of 40% and a specificity of 94-97%. Conclusion: Tono-Pen allows measurement of IOP to personal with no tonometric experience. There is a strong correlation between measurements obtained with both tonometers. Tono-Pen shows a tendency to underestimate high IOP and offers low sensitivity in detecting IOP greater than 21 mmHg (AU)