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BMC Ophthalmol. 2015 Apr 10;15:36. doi: 10.1186/s12886-015-0028-9.

Repeatability and reproducibility of applanation resonance tonometry: a cross-sectional study.

Author information

1
Eye Clinic, Dipartimento di Scienze della Salute, San Paolo Hospital, University of Milan, Milan, Italy. laura.ottobelli@gmail.com.
2
Eye Clinic, Dipartimento di Scienze della Salute, San Paolo Hospital, University of Milan, Milan, Italy. fogagnolopaolo@googlemail.com.
3
Dipartimento di scienze oftalmologiche e neurochirurgiche, Università degli Studi di Siena, Siena, Italy. frezzottip@unisi.it.
4
Eye Clinic, Dipartimento di Scienze della Salute, San Paolo Hospital, University of Milan, Milan, Italy. stefano_de_cilla@yahoo.co.uk.
5
Eye Clinic, Azienda Ospedaliero-Universitaria Maggiore della Carità, Novara, Italy. stefano_de_cilla@yahoo.co.uk.
6
Eye Clinic, Dipartimento di Scienze della Salute, San Paolo Hospital, University of Milan, Milan, Italy. elena.vallenzasca@virgilio.it.
7
Eye Clinic, Dipartimento di Scienze della Salute, San Paolo Hospital, University of Milan, Milan, Italy. mauriziodigiuni@gmail.com.
8
Eye Clinic, Dipartimento di Scienze della Salute, San Paolo Hospital, University of Milan, Milan, Italy. doctorpaderni@email.it.
9
Dipartimento di scienze oftalmologiche e neurochirurgiche, Università degli Studi di Siena, Siena, Italy. ilaria.motolese@libero.it.
10
Dipartimento di scienze oftalmologiche e neurochirurgiche, Università degli Studi di Siena, Siena, Italy. bagasimo@gmail.com.
11
Dipartimento di scienze oftalmologiche e neurochirurgiche, Università degli Studi di Siena, Siena, Italy. motolese@unisi.it.
12
Eye Clinic, Dipartimento di Scienze della Salute, San Paolo Hospital, University of Milan, Milan, Italy. luca.rossetti@unimi.it.

Abstract

BACKGROUND:

To assess repeatability (intra-observer variability) and reproducibility (inter-operator variability) of intraocular pressure (IOP) measurements with servo-controlled Bioresonator Applanation Resonance Tonometry (ART) and to evaluate possible influential factors.

METHODS:

The study included 178 patients (115 glaucoma and 63 controls; one eye per subject). IOP was measured once with a Goldmann applanation tonometer (GAT) and twice by ART (ART1, ART2), in randomized sequence, by a single operator to assess intra-operator variability. Each ART measurement consisted on 3 readings. To assess inter-operator variability 2 evaluators performed 2 measurements each (in random order) on the same patient. Repeatability and reproducibility were assessed by the coefficient of variation (CoV) and intraclass correlation coefficient (ICC).

RESULTS:

In the entire cohort, ART1 was 0.4 ± 2.2 mmHg (-7.0 to 5.7 mmHg) higher than ART2 (p = 0.03) regardless of test order. Intra-operator CoV was 7.0% ± 6.3%, and ICC was 0.80-0.92. Inter-operator CoV ranged between 5.7% ± 6.1% and 8.2% ± 7.2%, and ICC between 0.86 and 0.97. ART1 and 2 were respectively 1.7 ± 3.1 and 1.3 ± 3.1 mmHg higher than GAT (p < 0.01). Test-retest difference with ART fell within ±1 mmHg in 41% of cases, within ±2 mmHg in 70%, within ±3 mmHg in 85%. 15% had a test-retest difference higher than ± 3 mmHg; Bland-Altman 95% intervals of confidence were -3.9 and +4.6 mmHg. Results were unaffected by age, diagnosis, central corneal thickness, keratometry, operator, randomization sequence.

CONCLUSIONS:

In most cases ART repeatability and reproducibility were high, with no differences due to patients' characteristics. ART measurements overestimated GAT by a mean of 1.3-1.7 mmHg.

PMID:
25885814
PMCID:
PMC4409994
DOI:
10.1186/s12886-015-0028-9
[Indexed for MEDLINE]
Free PMC Article

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