Optic nerve head morphometry in healthy adults using confocal laser scanning tomography.

BACKGROUND/AIMS: To study the optic nerve head (ONH) characteristics in a cross sectional study with confocal laser scanning tomography using the Heidelberg retina tomograph (HRT I) and thereby to obtain a new HRT database for comparison of healthy and glaucomatous eyes. METHODS: White adults with no history of ocular pathology were eligible for the study. The examination comprised: assessment of visual acuity; slit lamp examination of the anterior and posterior segment; Goldmann applanation tonometry; computerised perimetry, and optic nerve head tomography with HRT. Eyes with ocular pathology were excluded. Mean (standard deviation, SD) and difference between right and left eye (RE-LE) were calculated for HRT I measurements. Differences in mean topographic parameters between male and female participants and between the age quartiles were analysed. The study included 1764 eyes of 882 healthy adults (154 females and 728 males, mean age of 46.8 (SD 8.6) years). The population investigated was larger and older in comparison with similar studies using confocal laser scanning tomography. RESULTS: With HRT I, a mean disc area of 1.82 (SD 0.39) mm(2), a mean cup area of 0.44 (SD 0.32) mm(2) and a mean cup:disc area ratio of 0.22 (SD 0.13) was observed. Right eyes showed a larger mean retinal nerve fibre layer thickness (RNFLT) (0.263 (SD 0.066) mm) compared with left eyes (0.252 (SD 0.065) mm, p<0.001). Higher values in younger volunteers (mean age 35.7 years) in comparison with elderly participants (mean age 59.1 years) were noted for disc area (1.84 mm(2)v 1.78 mm2) and mean RNFLT (0.263 (SD 0.06) mm v 0.249 (SD 0.07) mm) but were not significant (p>0.01). The presented results differ from published data on ONH measurements of healthy volunteers with different techniques. CONCLUSION: The observed differences in ONH measurements between left and right eyes seem not to be of clinical importance. This is also true for age or sex dependent changes in ONH topographies. The presented data provide a new basis for comparison of optic disc characteristics between healthy eyes and glaucomatous eyes.

Self-tonometry with the Ocuton S versus Goldmann tonometry.

BACKGROUND: The purpose of the study was to evaluate the acceptance and reproducibility of a new self-tonometer (Ocuton S) and to compare it with the Goldmann applanation tonometer. METHODS: The Ocuton S was studied in 20 healthy volunteers and 100 patients. After detailed explanation to each individual and a number of test measurements, we studied the reproducibility and accuracy of the Ocuton S in 20 healthy volunteers with and without topical anaesthesia. Acceptance was graded by means of visual analogue scales. Each volunteer had to measure his/her own IOP in three consecutive measurements. The data were compared with Goldmann tonometry at random times. One hundred patients were introduced to the Ocuton S. Either three consecutive self-measurements of IOP were performed and then compared with three consecutive measurements by Goldmann tonometry, or vice versa. This was done randomly. RESULTS: Forty-one of 100 patients were unable to perform three consecutive measurements with the Ocuton S after at least 15 min introduction time to the device (non-success). Fifty-nine of 100 patients were able to measure their IOP with the Ocuton S. The mean pressure value with the Ocuton S was 23.2+/-8.2 mmHg, compared with Goldmann 18. 4+/-5.7 mmHg. The difference of 5+/-5.7 mmHg was statistically significant (paired t-test p<0.01). The visual analogue scale scores of healthy volunteers (100 mm = maximal comfort, 0 mm = not acceptable), was 72+/-31 in anaesthetised eyes and 39+/-41 mm without anaesthesia. CONCLUSION: The Ocuton S seems to be an acceptable means for the majority of patients of measuring their IOP at home. Refinement of the accuracy of the device seems necessary.