切换至 "中华医学电子期刊资源库"
高级检索
中华眼科医学杂志(电子版)

中华眼科医学杂志(电子版) ›› 2019, Vol. 09 ›› Issue (03) : 140 -145. doi: 10.3877/cma.j.issn.2095-2007.2019.03.003

论著

两种非接触眼压计临床应用效果及其关联因素的临床研究
张青蔚1, 翟长斌1,†(), 张晶1, 郑燕1, 王玥1, 柳静1, 王宁利1, 周跃华1   
  1. 1. 100073　首都医科大学附属北京同仁医院　北京同仁眼科中心　北京市眼科学与视觉科学重点实验室
  • 收稿日期:2019-05-19 出版日期:2019-06-28
  • 通信作者: 翟长斌
  • 基金资助:
    2016年市科委"首都临床特色应用研究"专项课题(Z161100000516115)

Comparisons on the correlation and agreement between two non-contact tonometers

Qingwei Zhang1, Changbin Zhai1,†(), Jing Zhang1, Yan Zheng1, Yue Wang1, Jing Liu1, Ningli Wang1, Yuehua Zhou1   

  1. 1. Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Key Laboratory of Ophthalmology and Visual Science, Beijing Tongren Hospital, Capital Medical University, Beijing 100073, China
  • Received:2019-05-19 Published:2019-06-28
  • Corresponding author: Changbin Zhai
全文 ( ) 下载PDF ( ) 导出引用
引用本文：

张青蔚, 翟长斌, 张晶, 郑燕, 王玥, 柳静, 王宁利, 周跃华. 两种非接触眼压计临床应用效果及其关联因素的临床研究[J]. 中华眼科医学杂志(电子版), 2019, 09(03): 140-145.

Qingwei Zhang, Changbin Zhai, Jing Zhang, Yan Zheng, Yue Wang, Jing Liu, Ningli Wang, Yuehua Zhou. Comparisons on the correlation and agreement between two non-contact tonometers[J]. Chinese Journal of Ophthalmologic Medicine(Electronic Edition), 2019, 09(03): 140-145.

目的

探讨两种非接触眼压计测量的眼压(IOP)值之间的关联性及一致性，及其与中央角膜厚度(CCT)、陡峭角膜曲率(Ks)和平坦角膜曲率(Kf)的关联性。

方法

横断面研究。收集2018年3月至2018年4月在首都医科大学附属北京同仁医院眼科屈光中心招募的71例(142只眼)健康志愿者的眼科资料，依次使用CanonTX20型非接触气动眼压计测量IOP，VX120型多参数测量系统测量IOP、校正IOP及CCT，角膜地形图测量Ks、Kf。采用Wilcoxon秩和检验分析两种非接触眼压计测量的IOP值之间的关联性及一致性。应用Spearman相关分析分析非接触眼压计测量的IOP值与CCT、Ks和Kf的相关性；应用Bland-Altman以及95%的一致性界限(LoA)分析两种非接触眼压测量计的一致性。

结果

CanonTX20、VX120测量的IOP和校正后的VX120测量的IOP分别为(15.7±2.5)mmHg(1 mmHg＝0.133 kPa)、(16.7±3.4)mmHg、(16.8±3.3)mmHg，其不同性别间的差异无统计学意义(Z＝0.295，0.366，0.131；P>0.05)。VX120测量的IOP值比CanonTX20测量的IOP值高(1.007±2.651)mmHg，两者之间差异有统计学意义(t＝-4.527，P<0.05)。CanonTX20、VX120测量的IOP分别与VX120、Lenstar LS900测量的CCT有相关性(r＝0.177，0.167，0.221，0.178；P<0.05)。校正后的VX120测量的IOP和VX120、Lenstar LS900测量的CCT无相关性(r＝0.026，-0.001，0.026；P>0.05)。三种方式测量的IOP与Ks及Kf的相关性均无统计学意义(r＝0.158，0.158；P>0.05)。通过Bland-Altman以及95%LoA分析显示两者的95%LoA为±5.2 mmHg。年龄和IOP之间无明显的线性趋势。

结论

CanonTX20测量的IOP值和VX120测量的IOP值一致性较差，说明不可相互替代；CCT与CanonTX20及VX120测量的IOP值均存在相关性，但CCT与校正后的VX120测量的IOP值无相关性；Ks和Kf与IOP值均无相关性。

关键词: 非接触眼压计, 眼压, 角膜曲率, 角膜厚度, 相关分析
Objective

The aim of this study was to explore the correlation and the agreement between the intraocular pressure (IOP) measured by two different non-contact tonometers in healthy eyes and evaluate the impact of central corneal thickness (CCT) and corneal curvature (Ks, Kf) on the IOP measurements.

Methods

In the cross-sectional study, the case data of 71 patients (142 eyes) who were examined in Beijing Tongren Eye Center of Capital Medical University were collected from March 2018 to April 2018. IOP was measured sequentially with the Canon TX20 (Canon Inc., Janpan), VX120 (Luneau Technology USA), including CCT corrected IOP . CCT was measured using VX120. Ks and Kf were measured using Corneal Topographer. The relationships between different parameters and the measured IOP with each device were evaluated by Wilcoxon test with Spearman correlation analysis. Bland-Altman plot and 95% limit of agreement (LoA) of IOPs was analyzed.

Results

The IOP measured by CanonTX20, VX120 and IOP measured by VX120 after correction were (15.7±2.5) mmHg (1 mmHg=0.133 kPa), (16.7±3.4) mmHg, (16.8±3.3) mmHg, respectively; and IOP among of them were not shown the statistically on the gender (Z=0.295, 0.366, 0.131; P>0.05). There was a positive correlation between IOP measured by CanonTX20 , VX120 and CCT measured by VX120, Lenstar LS900(r=0.177, 0.167, 0.221, 0.178; P<0.05). There was not shown a correlation between corrected IOP measured by VX120 and CCT measured by VX120, Lenstar LS900 (r=0.026, r=-0.001; P>0.05). The correlation coefficients of IOP measured by three methods, Ks and Kf were not statistically significant (r=0.158, 0.158; P>0.05). The IOP measured by CanonTX20 was (1.007±2.651) mmHg higher than that measured by CanonTX20 (t=-4.527, P<0.05). Blander-Altman plot and 95% consistency threshold analysis showed that 95% LoA of them was ± 5.2 mmHg. Additionally, there was no obvious linear trend between age and IOP.

Conclusion

The IOP measured by CanonTX20 and VX120 were shown a bad consistency, which suggesting they cannot be used interchangeably to measure IOP in clinical practice. There was a correlation between CCT and IOP measured by CanonTX20, VX120, but there was no correlation between corrected IOP measured by VX120 and CCT. The correlations between Ks, Kf and IOP were not found.

Key words: Non-contact tonometer intraocular pressure, Corneal curvature, Corneal thickness, Correlation analysis
图4 3种方法测得的眼压与性别的关系箱式图　图4A~4C分别示CanonTX20、VX120和VX120测量的校正的眼压值在不同性别间的分布情况
[1]
王宁利，乔春艳．重视青光眼临床诊断和治疗的规范化[J]. 中华眼科杂志，2018, 54(3)：161-163.
[2]
熊公平，刘维锋，李颖洁. 近视眼角膜形态与眼压关系的研究[J]. 江西医药，2014, 49(9): 889-891.
[3]
Raul M, David P, Jaime J, et al. Intrasubject repeatability of corneal morphologymeasurements obtained with a new Scheimpflug photography-based system[J]. J Cataract Refract Surg, 2012, 38(6)：971-977.
[4]
Bland JM, Altman DG. Statistical methods for assessing agreement between two methods of clinical measurement[J]. Lancet, 1986, 1(8476)：307-310.
[5]
Smedowski A, Weglarz B, Tarnawska D, et al. Comparison of three intraocular pressure measurement methods including biomechanical properties of the cornea[J]. Invest Ophthalmol Vis Sci, 2014, 55(2)：666-673.
[6]
郝洁，甄毅，马建民，等．青光眼眼压监测的研究进展[J]．中华眼科杂志，2013, 49(9)：851-856.
[7]
葛坚，刘炳乾，高前应．角膜厚度与青光眼危险性的关系[J]. 眼科，2005, 14(3)：145-146.
[8]
Carbonaro F, Andrew T, Mackey DA, et al. Heritability of intraocular pressure: a classical twin study[J]. Br J Ophthalmol, 2008, 92(8)：1125-1128.
[9]
Chang TC, Congdon NG, Wojciechowski R, et al. Determinants and heritability of intraocular pressure and cup-to-disc ratio in a defined older population[J]. Ophthalmology, 2005, 112(7)：1186-1191.
[10]
Weih LM, Mukesh BN, McCarty CA, et al. Association of demographic, familial, medical, and ocular factors with intraocular pressure[J]. Arch Ophthalmol, 2001, 119(6)：875-880.
[11]
Wang D, Huang W, Li Y, et al. Intraocular pressure, central corneal thickness, and glaucoma in Chinese adults: the liwan eye study[J]. Am J Ophthalmol, 2011, 152(3)：454-462.
[12]
Doughty MJ, Zaman ML. Human corneal thickness and its impact on intraocular pressure measures: a review and meta-analysis approach[J]. Surv Ophthalmol, 2000, 44(5)：367-408.
[13]
Cheng AC, Fan D, Tang E, et al. Effect of corneal curvature and corneal thickness on the assessment of intraocular pressure using noncontact tonometry in patients after myopic LASIK surgery[J]. Cornea, 2006, 25(1)：26-28.
[14]
Liu J, Roberts CJ. Influence of corneal biomechanical properties on intraocular pressure measurement: quantitative analysis[J]. J Cataract Refr Surg, 2005, 31(1)：146-155.
[15]
Kontiola AI. A new induction-based impact method for measuring intraocular pressure[J]. Acta Ophthalmol Scandinavica, 2000, 78(2)：142-145.
[16]
Schlote T, Landenberger H. Intraocular pressure difference in Goldmann applanation tonometry versus a transpalpebral tonometer TGDc-01 "PRA" in glaucoma patients[J]. Klinische Monatsblatter fur Augenheilkunde, 2005, 222(2)：123-131.
[17]
Kaufmann C, Bachmann LM, Thiel MA. Comparison of dynamic contour tonometry with goldmann applanation tonometry[J]. Invest Ophthalmol Vis Sci, 2004, 45(9)：3118-3121.
[18]
沈伟，丁洁，李龙标. 角膜厚度对眼压测定的影响[J]. 中国实用眼科杂志，2001, 19(8)：579-581.
[19]
Kageyama M, Hirooka K, Baba T, et al. Comparison of ICare rebound tonometer with noncontact tonometer in healthy children[J]. J Glaucoma, 2011, 20(1)：63-66.
[20]
Stevens S, Gilbert C, Astbury N. How to measure intraocular pressure: applanation tonometry[J]. Community Eye Health, 2007, 20(64)：74-75.
[21]
Grolman B. A new tonometer system[J]. Am J Optom Arch Am Acad Optom，1972, 49(8)：646-660.
[22]
Shah S, Laiquzzaman M, Cunliffe I, et al. The use of the Reichert ocular response analyser to establish the relationship between ocular hysteresis, corneal resistance factor and central corneal thickness in normal eyes[J]. Contact Lens Anterior Eye, 2006, 29(5)：257-262.
[23]
Spoerl E, Terai N, Scholz F, et al. Detection of biomechanical changes after corneal cross-linking using Ocular Response Analyzer software[J]. J Refract Surg, 2011, 27(6)：452-457.
[24]
Han Z, Tao C, Zhou D, et al. Air puff induced corneal vibrations: theoretical simulations and clinical observations[J]. J Refract Surg, 2014, 30(3)：208-213.
[25]
Pinero DP. Technologies for anatomical and geometric characterization of the corneal structure and anterior segment: a review[J]. Semin Ophthalmol, 2015, 30(3)：161-170.
[26]
Piñero DP, López-Navarro A, Cabezos I, et al. Corneal topographic and aberrometric measurementsobtained with a multidiagnostic device in healthy eyes：intrasession repeatability[EB/OL]. (2017-01-04)[2019-03-25]．

URL    
[27]
Memarzadeh F, Ying-Lai M, Azen SP, et al. Associations with intraocular pressure in Latinos: the Los Angeles Latino Eye Study[J]. Am J Ophthalmol. 2008, 146(1)：69-76.
[28]
Foster PJ, Machin D, Wong TY, et al. Determinants of intraocular pressure and its association with glaucomatous optic neuropathy in Chinese Singaporeans: the Tanjong Pagar Study[J]. Invest Ophth Vis Sci, 2003, 44(9)：3885-3891.
[29]
Foster PJ, Broadway DC, Garway-Heath DF, et al. Intraocular pressure and corneal biomechanics in an adult British population: the EPIC-Norfolk eye study[J]. Invest Ophth Vis Sci, 2011, 52(11)：8179-8185.
[30]
Xu L, Li J, Zheng Y, et al. Intraocular pressure in Northern China in an urban and rural population: the Beijing eye study[J]. Am J Ophthalmol, 2005, 140(5)：913-915.
[31]
Klein BE, Klein R, Linton KL. Intraocular pressure in an American community: the Beaver Dam Eye Study[J]. Invest Ophth Vis Sci, 1992, 33(7)：2224-2228.
[32]
Kawase K, Tomidokoro A, Araie M, et al. Ocular and systemic factors related to intraocular pressure in Japanese adults: the Tajimi study[J]. Br J Ophthalmol, 2008, 92(9)：1175-1179.
[33]
Jonas JB, Nangia V, Matin A, et al. Intraocular pressure and associated factors: the central India eye and medical study[J]. J Glaucoma, 2011, 20(7)：405-409.
[34]
Firat PG, Orman G, Doganay S, et al. Influence of corneal parameters in keratoconus on IOP readings obtained with different tonometers[J]. Clin Exp Optom, 2013, 96(2)：233-237.
[35]
李福生，尹鸿芝，魏胜兰，等. 飞秒激光LASIK术后角膜生物力学各指标和眼压的改变[J]. 眼科新进展，2013, 33(2)：175-177.
[36]
邓铮铮，张晶，周跃华. 近视性屈光参差患者双眼角膜生物力学及眼压特点研究[J]. 眼科，2011, 20(2)：116-120.
[37]
Guo ZZ, Chang K, Wei X. Intraocular pressure fluctuation and the risk of glaucomatous damage deterioration: a Meta-analysis[J]. Int J Ophthalmol, 2019, 12(1)：127-132.
[38]
Pang Y, Li Y, Wang X, et al. A contact lens promising for non-invasive continuous intraocular pressure monitoring[J]. RSC Adv, 2019, 9(9)：5076-5082.
[39]
Lee JO, Narasimhan V, Balakrishna A, et al. Fabry-Pérot optical sensor and portable detector for monitoring high-resolution ocular hemodynamics[J]. IEEE Photonic Tech L, 2019, 31(6)：423-426.
[40]
Januleviciene I, Harris A. Biophysical properties in glaucoma[M]//Siaudvytyte L. Ocular perfusion pressure as a risk factor. Cham: Springer International Publishing, 2019.
[41]
Huang L, Chen Y, Lin Y, et al. Genome-wide analysis identified 17 new loci influencing intraocular pressure in Chinese population[J]. Science China-Life Sci, 2019, 62(2)：153-164.
[42]
纪康康，张学勇，廖荣丰. 不同测量工具下FS-LASIK手术前后眼压测量值一致性及测量变化值影响因素分析[J]. 安徽医学，2018, 39(9)：1039-1043.
[43]
Kato Y, Nakakura S, Matsuo N, et al. Agreement among Goldmann applanation tonometer, iCare, and Icare PRO rebound tonometers; non-contact tonometer; and Tonopen XL in healthy elderly subjects[J]. Int Ophthalmol, 2018, 38(2)：687-696.
[44]
Yildiz A, Yasar T. Comparison of Goldmann applanation, non-contact, dynamic contour and tonopen tonometry measurements in healthy and glaucomatous eyes, and effect of central corneal thickness on the measurement results[J]. Medicinski glasnik: official publication of the Medical Association of Zenica-Doboj Canton, Bosnia and Herzegovina, 2018, 15(2)：152-157.
[1] 曾舒涵, 庾楠楠, 应道静, 陈丽植, 容丽萍, 莫樱, 蒋小云. 激素敏感型原发性肾病综合征患儿激素治疗巩固维持阶段不同减量方案比较[J]. 中华妇幼临床医学杂志(电子版), 2022, 18(04): 468-475.
[2] 冷玥祺, 廖衍沣, 武歆纯, 李美瑶, 石逸雯, 王晋豪, 杨嘉瑞, 李学民. 环境因素对眼部生理与病理影响的研究进展[J]. 中华眼科医学杂志(电子版), 2023, 13(02): 109-113.
[3] 李茹月, 庞睿奇, 王宁利. 血脂异常与原发性开角型青光眼发病相关性的研究进展[J]. 中华眼科医学杂志(电子版), 2023, 13(01): 35-39.
[4] 王柠, 王佳伟, 刘旭阳. 重视眼颅压力差在多学科领域的应用[J]. 中华眼科医学杂志(电子版), 2022, 12(06): 321-325.
[5] 付玥川, 陶晨. 角膜塑形镜对儿童青少年低度近视眼进展控制长期效果及其影响因素的临床研究[J]. 中华眼科医学杂志(电子版), 2022, 12(05): 287-292.
[6] 师宜鹏, 孙文英, 谢立科, 解晓斌. 选择性激光小梁成形术的研究进展[J]. 中华眼科医学杂志(电子版), 2022, 12(04): 237-241.
[7] 王子杨, 杨文利. 关注屈光性白内障手术时代的精准眼球生物测量[J]. 中华眼科医学杂志(电子版), 2022, 12(04): 193-197.
[8] 雷蕊莲, 赵军梅, 唐桂兰. 微导管辅助微创青光眼手术研究的新进展[J]. 中华眼科医学杂志(电子版), 2022, 12(03): 178-182.
[9] 黄瑶, 邵蕾, 杨婧研, 李培, 魏文斌. 玻璃体腔注药术后早期眼压测量必要性的临床研究[J]. 中华眼科医学杂志(电子版), 2021, 11(06): 353-358.
[10] 马铭绅, 范懿, 李月月, 苏帆, 杨新吉. 甲状腺相关眼病继发性高眼压和青光眼发病机制与治疗的研究进展[J]. 中华眼科医学杂志(电子版), 2020, 10(06): 380-384.
[11] 白大勇, 李莉, 魏士飞, 李思珍, 张烨, 郝洁, 王宁利. 成人睫状肌麻痹前后屈光度变化及其影响因素的流行病学研究[J]. 中华眼科医学杂志(电子版), 2020, 10(03): 166-171.
[12] 李妍, 陈佩卿, 陈子和, 徐佳, 陶永钢. 三种非甾体抗炎药物在超声乳化白内障吸除联合人工晶状体植入术围手术期的应用研究[J]. 中华眼科医学杂志(电子版), 2020, 10(02): 103-109.
[13] 牟大鹏, 唐炘, 安文在, 李蕾, 卿国平, 宋彦铮, 时毅. 超声睫状体成形术治疗难治性青光眼半年随访效果的临床研究[J]. 中华眼科医学杂志(电子版), 2019, 09(06): 366-371.
[14] 李刚, 耿安姝, 白若濛, 赵立华. 屈光不正人群角膜上皮分布特征与角膜厚度的相关性研究[J]. 中华临床医师杂志(电子版), 2021, 15(11): 852-857.
[15] 张二明, 宋萍萍, 赵春燕, 安欣华, 马石头, 包曹歆, 李敏, 孙培培, 时延伟, 向平超. 北京十家社区40岁以上居民肺通气功能调查及影响因素分析[J]. 中华临床医师杂志(电子版), 2021, 15(05): 375-381.
阅读次数
全文


摘要

版权所有 中华医学会 中华医学电子音像出版社有限责任公司  京ICP备14006079号-1  网络出版服务许可证：(署)网出证(京)字第075号