Real-world agreement of same-visit Tono-Pen vs Goldmann applanation intraocular pressure measurements using electronic health records.
Heliyon
; 9(8): e18703, 2023 Aug.
Article
en En
| MEDLINE
| ID: mdl-37576221
ABSTRACT
Purpose:
To compare intraocular pressure (IOP) obtained with Tono-Pen (TP) and Goldmann applanation (GAT) using large-scale electronic health records (EHR).Design:
Retrospective cohort study.Methods:
A single pair of eligible TP/GAT IOP readings was randomly selected from the EHR for each ophthalmology patient at an academic ophthalmology center (2013-2022), yielding 4550 eligible measurements. We used Bland-Altman analysis to describe agreement between TP/GAT IOP differences and mean IOP measurements. We also used multivariable logistic regression to identify factors associated with different IOP readings in the same eye, including demographics, glaucoma diagnosis, and central corneal thickness (CCT). Primary outcome metrics were discrepant measurements between TP and GAT as defined by twomethods:
Outcome A (normal TP despite elevated GAT measurements), and Outcome B (TP and GAT IOP differences ≥6 mmHg).Result:
The mean TP/GAT IOP difference was 0.15 mmHg ( ± 5.49 mmHg 95% CI). There was high correlation between the measurements (r = 0.790, p < 0.001). We found that TP overestimated pressures at IOP <16.5 mmHg and underestimated at IOP >16.5 mmHg (Fig. 4). Discrepant measurements accounted for 2.6% (N = 116) and 5.2% (N = 238) for outcomes A and B respectively. Patients with thinner CCT had higher odds of discrepant IOP (OR 0.88 per 25 µm increase, CI [0.84-0.92], p < 0.0001; OR 0.88 per 25 µm increase, CI [0.84-0.92], p < 0.0001 for outcomes A and B respectively).Conclusion:
In a real-world academic practice setting, TP and GAT IOP measurements demonstrated close agreement, although 2.6% of measurements showed elevated GAT IOP despite normal TP measurements, and 5.2% of measurements were ≥6 mmHg apart.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Tipo de estudio:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Aspecto:
Patient_preference
Idioma:
En
Revista:
Heliyon
Año:
2023
Tipo del documento:
Article
País de afiliación:
Estados Unidos