PASCAL动态轮廓眼压计与Goldmann压平眼压计在非青光眼人群中眼压测量值的比较及一致性分析

目的探讨在不同的中央角膜厚度(CCT)下PASCAL动态轮廓眼压计(DCT)与Goldmann压平眼压计(GAT)眼压(IOP)测量值的相关性,评价两者测量值的一致性及临床上两种眼压计测量值相互替换的可能性。方法非青光眼病例87例(168只眼)分别用DCT和GAT进行眼压测量,两种仪器的测量顺序随机。同时,用NIDEK UP-1000型角膜测厚仪测量CCT。DCT与GAT眼压测量值的相关性采用Spearson双变量相关分析,Bland-Altman分析法评价两种仪器IOP测量值的一致性。结果 (1)在不同的角膜厚度下DCT与GAT测得的IOP值均显著相关(CCT≤520μm,n=24,r=0.67,P<0.001;520μm580μm,n=44,r=0.61,P<0.001)。(2)DCT眼压测量值与CCT不相关(r=0.14,P=0.08),GAT眼压测量值与CCT显著相关(r=0.59,P<0.001)。(3)Bland-Altman一致性分析显示两种仪器的差值的均值为-0.9mm Hg,一致性界限为(-5.6 mm Hg,3.9 mm Hg)。结论 (1)在不同的角膜厚度下DCT与GAT的眼压测量值均显著相关。(2)DCT眼压测量值与CCT值不相关,GAT眼压测量值与CCT值显著相关。(3)一致性分析显示两者测量值的一致性界限跨度较宽,二者的IOP值不可简单地相互代替。

Comparison of PASCAL dynamic contour tonometry and Goldmann applanation tonometry in nonglaucomatous eyes

Objective To investigate the correlation of intraocular pressure （IOP） obtained by PASCAL dynamic contour tonometry （DCT） and Coldmann applanation tonometry （CAT） in nonglaucomatous for central corneal thickness （CCT） and to evaluate the agreement and the interchangeablity of the IOP values obtained by the two instruments. Methods In a randomized order, two or three consecutive IOP measurements were performed on 168 eyes of 87 nonglaucomatons subjects by one examiner using the two instruments. Furthermore, the CCT was obtained by pachymetry of NIDEK UP- 1000. The Spearman correlation coefficient （r） were determined to compare lOP readings between DCT and GAT , CCT and DCT/GAT IOP values. Bland-Ahman analysis was applied to evaluate the agreement between the instruments. Results Mean IOP values obtained by both instruments were significantly correlated in different central corneal thickness （ CCT≤ 520 μm, n =24, r =0.67, P 〈0.001 ;520 μm 〈 CCT≤580 μm, n = 100, r =0.71, P 〈0.001 ;CCT 〉580 μm, n = 44, r =0.61, P 〈0.001）. GAT showed a significant correlation with CCT （ r =0.59, P 〈0.001）, while DCT showed no correlation with CCT （ r = 0. 14, P = 0.08 ）. Bland-Altman analysis revealed that the mean difference of two tonometers was -0.9mmHg, the95% limits of agreement was （-5.6mmHg,3.9mmHg）.Conclusion DCTand GAT revealed a strong correlation in IOP measurements even in different CCT. IOP obtained by GAT was correlated with CCT, while DCT was not. However, the analysis of agreement indicated a wide range of the two instruments, the IOP values obtained by the two instruments could not be exchanged straightforward in clinic.