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Kim, Lee, and Kim: Comparison of Intraocular Pressure via Goldmann-applanation Tonometry and TonoPen in Thyroid-associated Ophthalmopathy Accompanying Restrictive Strabismus
Original Article

Journal of the Korean Ophthalmological Society 2017; 58(6): 685-691.

Published online: 16 June 2017

DOI: https://doi.org/10.3341/jkos.2017.58.6.685

Comparison of Intraocular Pressure via Goldmann-applanation Tonometry and TonoPen in Thyroid-associated Ophthalmopathy Accompanying Restrictive Strabismus

Jun Sik Kim, MD, Eun Ji Lee, MD, PhD, Namju Kim, MD, PhD

Department of Ophthalmology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.

Address reprint requests to Eun Ji Lee, MD, PhD. Department of Ophthalmology, Seoul National University Bundang Hospital, #82 Gumi-ro 173beon-gil, Bundang-gu, Seongnam 13620, Korea. Tel: 82-31-787-7378, Fax: 82-31-787-4057, opticdisc@gmail.com

Received 15 December 2016       Revised 11 March 2017       Accepted 25 May 2017

©2017 The Korean Ophthalmological Society

(open-access):

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 Goldmann-applanation tonometry (GAT) and Tonopen® tonometry and to evaluate the factors influencing the measurement difference in patients with thyroid-associated ophthalmopathy (TAO)-related restrictive strabismus.

Methods

In 50 eyes of 50 patients who were diagnosed with TAO, IOP measurements were taken using both GAT and a Tonopen® and were subsequently compared between the devices. Factors influencing the measurement difference between the devices were determined, including the restriction of eyeball movement, eyeball deviation, exophthalmometry, central corneal thickness, refractive errors, and blood thyroid hormone levels.

Results

In the TAO patients, the GAT-measured IOP was higher than for Tonopen® (16.1 ± 4.7 vs. 13.8 ± 4.5 mmHg, respectively, p < 0.001). As the restriction of vertical eyeball movement increased, the IOP difference between the devices also increased (p = 0.037). The absolute IOP difference between the devices was positively correlated with restrictions in vertical eyeball movement (p = 0.027), degree of vertical strabismus (p = 0.021), and central corneal thickness (p ≤ 0.031).

Conclusions

In patients with TAO accompanying vertical eyeball movement restriction, potential errors in IOP measurements should be considered between the different IOP-measuring devices.

Keywords: Goldmann-applanation tonometry, Intraocular pressure, Restrictive strabismus, Thyroid-associated ophthalmopathy, Tonopen®

Figures and Tables

Table 1

Subjects clinical characteristics (n = 50)

jkos-58-685-i001

Values are presented as mean ± SD or n (%) unless otherwise indicated.

MD = mean deviation; PSD = pattern standard deviation; RNFL = retinal nerve fiber layer.

Table 2

Intraocular pressure measured using Goldmann applanation tonometery (IOPGAT) and Tonopen® (IOPTonoPen)

jkos-58-685-i002

Values are mean ± standard deviation (range).

*Statistically significant values.

Table 3

Factors associated with the difference between the intraocular pressure measured using Goldmann applanation tonometer (IOPGAT) and using Tonopen® (IOPTonoPen) (IOPGAT – IOPTonoPen)

jkos-58-685-i003

CI = confidence interval; EOM = extraocular muscle; PD = prism diopter; T3 = triiodothyronine; T4 = free thyroxine; TSH = thyroid stimulating hormone; MD = mean deviation; PSD = pattern standard deviation; RNFL = retinal nerve fiber layer.

*Statistically significant values.

Table 4

Factors associated with the absolute difference between the intraocular pressure measured using Goldmann applanation tonometer (IOPGAT) and using Tonopen® (IOPTonoPen) (| IOPGAT – IOPTonoPen |)

jkos-58-685-i004

CI = confidence interval; EOM = extraocular muscle; PD = prism diopter; T3 = triiodothyronine; T4 = free thyroxine; TSH = thyroid stimulating hormone; MD = mean deviation; PSD = pattern standard deviation; RNFL = retinal nerve fiber layer.

*Statistically significant values.

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