Comparison of Ocular Pulse Amplitude Measured Using Dynamic Contour Tonometry and Ocular Blood Flow Analyzer

Yong Hyun Kim; Mar Vin Lee; Jae Hong Ahn

doi:10.3341/jkos.2015.56.12.1906

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Kim, Lee, and Ahn: Comparison of Ocular Pulse Amplitude Measured Using Dynamic Contour Tonometry and Ocular Blood Flow Analyzer

Original Article

J Korean Ophthalmol Soc 2015;56(12):1906-1912.

Published online: 29 August 2015

DOI: https://doi.org/10.3341/jkos.2015.56.12.1906

Comparison of Ocular Pulse Amplitude Measured Using Dynamic Contour Tonometry and Ocular Blood Flow Analyzer

Yong Hyun Kim, M.D¹, Mar Vin Lee, M.D², Jae Hong Ahn, M.D, PhD^1,

¹Department of Ophthalmology, Ajou University School of Medicine, Suwon, Korea

²Department of Ophthalmology, Bundang Jesaeng Hospital, Seongnam, Korea

Address reprint requests to Jae Hong Ahn, MD, PhD Department of Ophthalmology, Ajou University Hospital, #164 World cup-ro, Yeongtong-gu, Suwon 16499, Korea Tel: 82-31-219-5261, Fax: 82-31-219-5909 E-mail: chrisahn@ajou.ac.kr

Received 6 February 201524 July 2015 Accepted 25 September 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 ocular pulse amplitude (OPA) measured using dynamic contour tonometry (DCT) and ocular blood flow analyzer (BFA).

Methods

Thirty-five eyes of 35 patients were enrolled in this cross-sectional and retrospective study. OPA was measured using DCT. Pulse amplitude (PA) and pulsatile ocular blood flow were measured using BFA.

Results

OPA measured using DCT (2.79 ± 0.89 mm Hg) was not significantly different from PA measured with BFA (3.02 ±0.90 mm Hg; p = 0.082) and both were significantly correlated (r = 0.663, p < 0.001). Mean difference ± limit of agreement was -0.22 ± 1.44 mm Hg between OPA and PA. OPA correlated significantly with intraocular pressure (IOP) measured using Goldmann applanation tonometry (r = 0.330, p = 0.047) but not PA (r = 0.057, p = 0.745). Both PA and OPA did not show sig-nificant correlation with the spherical equivalent of refractive error and central corneal thickness.

Conclusions

Although both OPA and PA measure IOP fluctuation and are not significantly different, they showed different rela-tionships with IOP.

Keywords: Intraocular pressure, Ocular blood flow, Ocular pulse amplitude

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Figure 1.

Agreement between intraocular pressure and ocular pulse amplitude measured by different devices. (A) Bland-Altman plot showing the inter-instrument repeatability of IOP measurements by DCT and GAT. (B) Bland-Altman plot showing the inter-instru-ment repeatability of IOP measurements by ocular BFA and GAT. (C) Bland-Altman plot showing the inter-instrument repeatability of IOP measurements by BFA and DCT. (D) Bland-Altman plot showing the inter-instrument repeatability of OPA measurements by DCT with measurements using BFA. GAT = Goldman applanation tonometry; IOP = intraocular pressure; DCT = dynamic contour tonometry; BFA = ocular blood flow analyzer; OPA = ocular pulse amplitude; PA = pulse amplitude measured by BFA; SD = standard deviation.

Table 1.

Descriptive statistics of enrolled subjects

Parameter	Mean ± SD	Minimum	Median value	Maximum
Age (years)	47.0 ± 10.4	31	45	71
Male/female ratio	17/18	-	-	-
MAP (mm Hg)	94.2 ± 10.1	70.3	94.7	115.7
PP (mm Hg)	50.3 ± 10.9	33	50	75
MOPP (mm Hg)	47.0 ± 6.8	33.9	46.7	60.2
PR (beats per minute)	77.8 ± 11.4	54	76	108
CCT (μ m)	545.84 ± 38.06	458.0	543.0	629.3
SE (diopters)	-2.036 ± -2.790	-9.50	-0.50	1.50
GAT IOP (mm Hg)	15.8 ± 3.17	10	15	21
DCT IOP (mm Hg)	20.01 ± 4.21	11.6	20.6	29.1
OPA (mm Hg)	2.79 ± 0.89	1.3	2.7	5.3
BFA IOP (mm Hg)	22.89 ± 5.78	12.8	22.9	35.9
PA (mm Hg)	3.02 ± 0.90	1.5	3.1	5.9
PV (μ L)	4.92 ± 1.75	1.8	4.9	9.5
POBF (μ L/sec)	12.21 ± 3.83	6.2	12.6	21.8

Values are presented as mean ± SD unless otherwise indicated. SD = standard deviation; MAP = mean arterial pressure; PP = pulse pressure; MOPP = mean ocular perfusion pressure; PR = pulse rate; CCT = central corneal thickness; SE = spherical equivalent; GAT = Goldmann applanation tonometry; IOP = intraocular pressure; DCT = dynamic contour tonometry; OPA = ocular pulse amplitude; BFA = ocular blood flow analyzer; PA = pulse amplitude measured by BFA; PV = pulse volume measured by BFA; POBF = pulsatile ocular blood flow measured by BFA.

Table 2.

Comparison of IOP differences measured by 3 different devices and correlations between IOP measurements

Compared parameters	Mean difference (± standard deviation)	p-value^*	LOA (mm Hg)	Range (mm Hg)	Correlation^† between two parameters	p-value
GAT IOP-DCT IOP	-4.2 ± 2.9	<0.001	-9.8, 1.4	11.2	0.733	<0.001
GAT IOP-BFA IOP	-7.1 ± 3.8	<0.001	-14.5, 0.3	14.8	0.795	<0.001
DCT IOP-BFA IOP	-2.9 ± 3.4	<0.001	-9.6, 3.9	13.6	0.808	<0.001
OPA-PA	-0.22 ± 0.74	0.082	-1.66, 1.22	2.88	0.663	<0.001

Values are presented as mean ± SD unless otherwise indicated. IOP = intraocular pressure; LOA = limit of agreement; GAT = Goldmann applanation tonometry; DCT = dynamic contour tonometry; BFA = ocular blood flow analyzer; OPA = ocular pulse amplitude measured by DCT; PA = pulse amplitude measured by BFA.^* Paired t-test; ^† Pearson correlation coefficient.

Table 3.

Correlations between IOP or OPA-derived parameters and systemic or other ocular parameters (Pearson correlation co-efficient R and p-value in parenthesis)

	Age	CCT	SE
GAT IOP	-0.211 (0.224)	0.296 (0.047)	-0.278 (0.106)
DCT IOP	-0.004 (0.980)	0.235 (0.174)	-0.268 (0.120)
BFA IOP	-0.258 (0.134)	0.144 (0.409)	-0.900 (0.079)
OPA	-0.031 (0.861)	-0.146 (0.404)	0.154 (0.376)
PA	0.123 (0.482)	-0.165 (0.344)	0.308 (0.072)
POBF	0.209 (0.228)	-0.339 (0.047)	0.431 (0.010)

IOP = intraocular pressure; OPA = ocular pulse amplitude measured by DCT; CCT = central corneal thickness; SE = spherical equivalent; GAT = Goldmann applanation tonometry; DCT = dynamic contour tonometry; BFA = ocular blood flow analyzer; PA = pulse amplitude measured by BFA; POBF = pulsatile ocular blood flow measured by BFA.

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