Comparison of Rebound Tonometry and Goldmann Applanation Tonometry in Restrictive Thyroid Eye Disease

Hye Won Park; Hye Young Kim

doi:10.3341/jkos.2015.56.12.1826

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Park and Kim: Comparison of Rebound Tonometry and Goldmann Applanation Tonometry in Restrictive Thyroid Eye Disease

Original Article

J Korean Ophthalmol Soc 2015;56(12):1826-1830.

Published online: 29 August 2015

DOI: https://doi.org/10.3341/jkos.2015.56.12.1826

Comparison of Rebound Tonometry and Goldmann Applanation Tonometry in Restrictive Thyroid Eye Disease

Hye Won Park, M.D^1,², Hye Young Kim, M.D^2,

¹The Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea

²Department of Ophthalmology, National Health Insurance Service Ilsan Hospital, Goyang, Korea

Address reprint requests to Hye Young Kim, MD Department of Ophthalmology, National Health Insurance Service Ilsan Hospital, #100 Ilsan-ro, Ilsandong-gu, Goyang 10444, Korea Tel: 82-31-900-0590, Fax: 82-31-900-0049 E-mail: khyeye@hanmail.net

‗ This study was presented as a poster at the 114th Annual Meeting of the Korean Ophthalmological Society 2015.

Received 30 July 201516 November 2015 Accepted 30 November 2015

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To compare the intraocular pressure (IOP) measured using the rebound tonometer (RT) and Goldmann applanation tonometer (GAT) in the primary position and upgaze in restrictive thyroid eye disease (TED).

Methods

We measured the IOP in 30 subjects (54 eyes) who visited an ophthalmologist between May 2014 and May 2015. This study included 16 healthy volunteers (32 eyes) and 14 TED patients (22 eyes). The outcome measurements were the compar-ison of IOP readings; both intergroup and 2 measurements using the RT and the GAT for patients with restrictive TED and the control group. Upgaze IOP was measured on the central cornea with a 20-degree chin-down posture.

Results

Both TED patients and controls showed an increase in IOP in upgaze compared with primary position ( p < 0.001). There was a significant difference in mean differential IOP between patients and controls measured using RT and GAT, respectively ( p < 0.001). In the control group, there was no significant difference between the 2 instrument readings in upgaze as well as primary position for patients with restrictive TED ( p = 0.853 in TED; p = 0.260 in controls).

Conclusions

Based on our results, the mean IOP in conventional upgaze was significantly increased in TED patients compared to primary position using both the RT and GAT and no difference in RT readings compared with GAT readings. The RT can be used to establish IOP since no significant difference between the upgaze and the primary position readings was observed in pa-tients with restrictive TED and is a simple and effective diagnostic tool unrelated to the position and the direction of gaze.

Keywords: Goldmann applanation tonometer, Intraocular pressure, Rebound tonometer, Restrictive thyroid eye disease

References

1. Nardi M, Bartolomei MP, Romani A, Barca L. Intraocular pressure changes in secondary positions of gaze in normal subjects and in restrictive ocular motility disorders. Graefes Arch Clin Exp Ophthalmol. 1988; 226:8–10.

2. Saunders RA, Helveston EM, Ellis FD. Differential intraocular pressure in strabismus diagnosis Ophthalmology. 1981; 88:59–70.

3. Zappia RJ, Winkelman JZ, Gay AJ. Intraocular pressure changes in normal subjects and the adhesive muscle syndrome. Am J Ophthalmol. 1971; 71:880–3.

4. Helveston EM, Bick SE, Ellis FD. Differential intraocular pressure as an indirect measure of generated muscle force. Ophthalmic Surg. 1980; 11:386–91.

5. Fishman DR, Benes SC. Upgaze intraocular pressure changes and strabismus in Graves' ophthalmopathy. J Clin Neuroophthalmol. 1991; 11:162–5.

6. Goldmann H, Schmidt T. Applanation tonometry. Ophthalmologica. 1957; 134:221–42.

7. Herzog D, Hoffmann R, Schmidtmann I. . Is gaze-dependent tonometry a useful tool in the differential diagnosis of Graves’ ophthalmopathy? Graefes Arch Clin Exp Ophthalmol. 2008; 246:1737–41.

8. Jorge J, Fernandes P, Queirós A. . Comparison of the IOPen and iCare rebound tonometers with the Goldmann tonometer in a normal population. Ophthalmic Physiol Opt. 2010; 30:108–12.

9. Fernandes P, Díaz-Rey JA, Queirós A. . Comparison of the ICare rebound tonometer with the Goldmann tonometer in a nor-mal population. Ophthalmic Physiol Opt. 2005; 25:436–40.

10. Nakamura M, Darhad U, Tatsumi Y. . Agreement of rebound tonometer in measuring intraocular pressure with three types of ap-planation tonometers. Am J Ophthalmol. 2006; 142:332–4.

11. Brusini P, Salvetat ML, Zeppieri M. . Comparison of ICare ton-ometer with Goldmann applanation tonometer in glaucoma patients. J Glaucoma. 2006; 15:213–7.

12. Martinez-de-la-Casa JM, Garcia-Feijoo J, Castillo A, Garcia-Sanchez J. Reproducibility and clinical evaluation of rebound tonometry. Invest Ophthalmol Vis Sci. 2005; 46:4578–80.

13. Kohlhaas M, Boehm AG, Spoerl E. . Effect of central corneal thickness, corneal curvature, and axial length on applanation tonometry. Arch Ophthalmol. 2006; 124:471–6.

14. Grieshaber MC, Schoetzau A, Zawinka C. . Effect of central corneal thickness on dynamic contour tonometry and Goldmann applanation tonometry in primary open-angle glaucoma. Arch Ophthalmol. 2007; 125:740–4.

15. Moreno-Montañés J, Gosende I, Caire J, García-Granero M. Comparation of the new rebound tonometer IOPen and the Goldmann tonometer, and their relationship to corneal properties. Eye (Lond). 2011; 25:50–6.

16. Moreno-Montañés J, García N, Fernández-Hortelano A, García-Layana A. Rebound tonometer compared with goldmann tonometer in normal and pathologic corneas. Cornea. 2007; 26:427–30.

17. Lee KS, Kim SK, Kim EK, Kim TI. Comparison of intraocular pressure measured by non-contact tonometer, rebound tonometer, tono-pen, and Goldmann applanation tonometer. J Korean Ophthalmol Soc. 2014; 55:47–53.

Figure 1.

Distribution of IOP using RT and GAT for the TED and controls in primary position and upgaze. The boundary of the box closest to zero indicates the 25th percentile, the line within the box marks the median, and the boundary of the box farthest from zero indicates the 75th percentile. Whiskers above and below the box indicate the maximum and minimum values. And empty circle indicate the outlier. IOP = intra-ocular pressure; RT = rebound tonometer; GAT = Goldmann applanation tonometer; TED = thyroid eye disease.

Table1.

Mean IOP measured by GAT and RT for the TED and controls in primary position and upgaze

	Primary position	Upgaze
TED
RT (mm Hg)	18.40 ± 2.76	24.60 ± 5.52 <0.001
GAT (mm Hg)	18.91 ± 2.91	25.27 ± 5.36 <0.001
p-value^†	0.554	0.684
Control
RT (mm Hg)	14.54 ± 2.15	16.27 ± 1.80 <0.001
GAT (mm Hg)	14.13 ± 2.17	15.53 ± 2.11 <0.001
p-value^†	0.440	0.139

Values are presented as mean ± SD unless otherwise indicated. IOP = intraocular pressure; GAT = Goldmann applanation ton-ometer; RT = rebound tonometer; TED = thyroid eye disease.^* p-value by paired t-test for intraocular pressure between primary gaze and upgaze; ^† p-value by unpaired t-test for intraocular pres-sure between Rebound and Goldmann applanation tonometer.

Table 2.

The difference of IOP between primary position and upgaze

	TED	Control	p-value^*
RT (mm Hg)	6.46 ± 4.45	1.72 ± 1.74	<0.001
GAT (mm Hg)	6.36 ± 4.60	1.41 ± 1.01	<0.001
p-value^†	0.852	0.260

Values are presented as mean ± SD unless otherwise indicated. IOP = intraocular pressure; TED = thyroid eye disease; RT = mean IOP difference (upgaze IOP-primary position IOP) using re-bound tonometer; GAT = mean IOP difference (upgaze IOP-pri-mary position IOP) using Goldmann applanation tonometer.^* p-value by unpaired t-test for intraocular pressure between TED and control; ^† p-value by unpaired t-test for intraocular pressure be-tween Rebound and Goldmann applanation tonometer.

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