ABSTRACT
PURPOSE: To compare intraocular pressure (IOP) measurements obtained using the new rebound tonometer Icare-Pro (Icare, Tiolat Oy, Helsinki, Finland) and the hand-held version of the Goldmann applanation tonometer (Perkins; Clement Clarke, Haag-Streit, Harlow, United Kingdom) in healthy children during clinical practice. METHODS: In this prospective study, three IOP measurements were made using each tonometer in a single session, starting with the Icare-Pro. Participants were 173 non-anesthetized patients aged 1 to 16 years. Measurements were made in both eyes but only data for the right eye were entered in the analysis. Central corneal thickness, anterior chamber depth, and axial length were also measured in each patient. Data were compared by determining interclass correlation coefficients (ICCs) for each tonometer and representing the differences detected as Bland-Altman plots. RESULTS: Good linear correlation was observed between IOP readings obtained using the Perkins and Icare-Pro tonometers (r = 0.87, P < .001), although the Icare-Pro readings were slightly higher (mean IOP difference: 0.26 ± 1.58 mm Hg, P = .037). The 95% limits of agreement between the two methods were 2.8 to -3.4 mm Hg. The ICC was 0.857 (95% confidence interval: 0.810 to 0.893), indicating good agreement. For both tonometers, a low but significant correlation was detected between IOP and central corneal thickness or age. However, no correlation of IOP was found with axial length or anterior chamber depth. CONCLUSIONS: Pediatric IOP measurements determined using the new Icare-Pro rebound tonometer showed good correlation with those obtained using the hand-held Perkins applanation tonometer in a routine clinical examination with no need for general anesthesia. [J Pediatr Ophthalmol Strabismus. 2018;55(6):382-386.].
Subject(s)
Glaucoma/diagnosis , Intraocular Pressure/physiology , Tonometry, Ocular/instrumentation , Adolescent , Child , Child, Preschool , Equipment Design , Female , Glaucoma/physiopathology , Humans , Infant , Male , Prospective Studies , Reproducibility of ResultsABSTRACT
INTRODUCTION: Septo-optic dysplasia (SOD) is the variable combination of signs of dysgenesis of the midline of the brain, hypoplasia of the optic nerves and hypothalamus-pituitary dysfunction, which is sometimes associated with a varied spectrum of malformations of the cerebral cortex. AIMS: To describe the natural history and neuroimaging findings in a series of 20 diagnosed patients. PATIENTS AND METHODS: We review the epidemiological, clinical and neuroimaging characteristics of 20 consecutive patients diagnosed with SOD between January 1985 and January 2010. Data obtained from computerised tomography, magnetic resonance imaging of the head, electroencephalogram, visual evoked potentials, ophthalmological evaluation, karyotyping and endocrinological studies were analysed. In seven patients, a study of the gene Homeobox HESX1 was conducted. RESULTS: Pathological antecedents in the first three months of gestation were presented by 60% of the cases, with normal results in the foetal ultrasound scans. Clinically, the most striking features were visual manifestations (85%), endocrine disorders (50%), mental retardation (60%) and epileptic seizures (55%). Fifty-five per cent were associated to abnormal neuronal migration. In 45%, SOD was the only finding in the neuroimaging scans. Karyotyping was performed in all cases, the results being normal. Gene HESX1 was positive in two of the seven cases studied (both with isolated SOD). None of those with mutation in gene HESX1 presented familial consanguinity. No gene study was conducted with the parents. CONCLUSIONS: SOD must be classified as a heterogeneous malformation syndrome, which is associated to multiple brain, ocular, endocrine and systemic anomalies. The most severe forms are associated with abnormal neuronal migration and cortical organisation.
