Systematic review of the agreement of tonometers with Goldmann applanation tonometry

Jonathan Alistair Cook; Adriana Paola Botello; Andrew Elders; Alia Fathi Ali; Augusto Azuara-Blanco; Cynthia Fraser; Kirsty McCormack; Jennifer Margaret Burr; Surveillance of Ocular Hypertension Study Group

doi:10.1016/j.ophtha.2012.02.030

Systematic review of the agreement of tonometers with Goldmann applanation tonometry

Jonathan Alistair Cook, Adriana Paola Botello, Andrew Elders, Alia Fathi Ali, Augusto Azuara-Blanco, Cynthia Fraser, Kirsty McCormack, Jennifer Margaret Burr, Surveillance of Ocular Hypertension Study Group

Research output: Contribution to journal › Article › peer-review

153 Citations (Scopus)

Abstract

OBJECTIVE: To assess the agreement of tonometers available for clinical practice with the Goldmann applanation tonometer (GAT), the most commonly accepted reference device.

DESIGN: A systematic review and meta-analysis of directly comparative studies assessing the agreement of 1 or more tonometers with the reference tonometer (GAT).

PARTICIPANTS: A total of 11 582 participants (15 525 eyes) were included.

METHODS: Summary 95% limits of agreement (LoA) were produced for each comparison.

MAIN OUTCOME MEASURES: Agreement, recordability, and reliability.

RESULTS: A total of 102 studies, including 130 paired comparisons, were included, representing 8 tonometers: dynamic contour tonometer, noncontact tonometer (NCT), ocular response analyzer, Ocuton S, handheld applanation tonometer (HAT), rebound tonometer, transpalpebral tonometer, and Tono-Pen. The agreement (95% limits) seemed to vary across tonometers: 0.2 mmHg (-3.8 to 4.3 mmHg) for the NCT to 2.7 mmHg (-4.1 to 9.6 mmHg) for the Ocuton S. The estimated proportion within 2 mmHg of the GAT ranged from 33% (Ocuton S) to 66% and 59% (NCT and HAT, respectively). Substantial inter- and intraobserver variability were observed for all tonometers.

CONCLUSIONS: The NCT and HAT seem to achieve a measurement closest to the GAT. However, there was substantial variability in measurements both within and between studies.

Original language	English
Pages (from-to)	1552-1557
Number of pages	6
Journal	Ophthalmology
Volume	119
Issue number	8
Early online date	01 May 2012
DOIs	https://doi.org/10.1016/j.ophtha.2012.02.030
Publication status	Published - 01 Aug 2012

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10.1016/j.ophtha.2012.02.030

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title = "Systematic review of the agreement of tonometers with Goldmann applanation tonometry",

abstract = "OBJECTIVE: To assess the agreement of tonometers available for clinical practice with the Goldmann applanation tonometer (GAT), the most commonly accepted reference device.DESIGN: A systematic review and meta-analysis of directly comparative studies assessing the agreement of 1 or more tonometers with the reference tonometer (GAT).PARTICIPANTS: A total of 11 582 participants (15 525 eyes) were included.METHODS: Summary 95% limits of agreement (LoA) were produced for each comparison.MAIN OUTCOME MEASURES: Agreement, recordability, and reliability.RESULTS: A total of 102 studies, including 130 paired comparisons, were included, representing 8 tonometers: dynamic contour tonometer, noncontact tonometer (NCT), ocular response analyzer, Ocuton S, handheld applanation tonometer (HAT), rebound tonometer, transpalpebral tonometer, and Tono-Pen. The agreement (95% limits) seemed to vary across tonometers: 0.2 mmHg (-3.8 to 4.3 mmHg) for the NCT to 2.7 mmHg (-4.1 to 9.6 mmHg) for the Ocuton S. The estimated proportion within 2 mmHg of the GAT ranged from 33% (Ocuton S) to 66% and 59% (NCT and HAT, respectively). Substantial inter- and intraobserver variability were observed for all tonometers.CONCLUSIONS: The NCT and HAT seem to achieve a measurement closest to the GAT. However, there was substantial variability in measurements both within and between studies.",

author = "Cook, {Jonathan Alistair} and Botello, {Adriana Paola} and Andrew Elders and {Fathi Ali}, Alia and Augusto Azuara-Blanco and Cynthia Fraser and Kirsty McCormack and {Margaret Burr}, Jennifer and {Surveillance of Ocular Hypertension Study Group}",

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doi = "10.1016/j.ophtha.2012.02.030",

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T1 - Systematic review of the agreement of tonometers with Goldmann applanation tonometry

AU - Cook, Jonathan Alistair

AU - Botello, Adriana Paola

AU - Elders, Andrew

AU - Fathi Ali, Alia

AU - Azuara-Blanco, Augusto

AU - Fraser, Cynthia

AU - McCormack, Kirsty

AU - Margaret Burr, Jennifer

AU - Surveillance of Ocular Hypertension Study Group

PY - 2012/8/1

Y1 - 2012/8/1

N2 - OBJECTIVE: To assess the agreement of tonometers available for clinical practice with the Goldmann applanation tonometer (GAT), the most commonly accepted reference device.DESIGN: A systematic review and meta-analysis of directly comparative studies assessing the agreement of 1 or more tonometers with the reference tonometer (GAT).PARTICIPANTS: A total of 11 582 participants (15 525 eyes) were included.METHODS: Summary 95% limits of agreement (LoA) were produced for each comparison.MAIN OUTCOME MEASURES: Agreement, recordability, and reliability.RESULTS: A total of 102 studies, including 130 paired comparisons, were included, representing 8 tonometers: dynamic contour tonometer, noncontact tonometer (NCT), ocular response analyzer, Ocuton S, handheld applanation tonometer (HAT), rebound tonometer, transpalpebral tonometer, and Tono-Pen. The agreement (95% limits) seemed to vary across tonometers: 0.2 mmHg (-3.8 to 4.3 mmHg) for the NCT to 2.7 mmHg (-4.1 to 9.6 mmHg) for the Ocuton S. The estimated proportion within 2 mmHg of the GAT ranged from 33% (Ocuton S) to 66% and 59% (NCT and HAT, respectively). Substantial inter- and intraobserver variability were observed for all tonometers.CONCLUSIONS: The NCT and HAT seem to achieve a measurement closest to the GAT. However, there was substantial variability in measurements both within and between studies.

AB - OBJECTIVE: To assess the agreement of tonometers available for clinical practice with the Goldmann applanation tonometer (GAT), the most commonly accepted reference device.DESIGN: A systematic review and meta-analysis of directly comparative studies assessing the agreement of 1 or more tonometers with the reference tonometer (GAT).PARTICIPANTS: A total of 11 582 participants (15 525 eyes) were included.METHODS: Summary 95% limits of agreement (LoA) were produced for each comparison.MAIN OUTCOME MEASURES: Agreement, recordability, and reliability.RESULTS: A total of 102 studies, including 130 paired comparisons, were included, representing 8 tonometers: dynamic contour tonometer, noncontact tonometer (NCT), ocular response analyzer, Ocuton S, handheld applanation tonometer (HAT), rebound tonometer, transpalpebral tonometer, and Tono-Pen. The agreement (95% limits) seemed to vary across tonometers: 0.2 mmHg (-3.8 to 4.3 mmHg) for the NCT to 2.7 mmHg (-4.1 to 9.6 mmHg) for the Ocuton S. The estimated proportion within 2 mmHg of the GAT ranged from 33% (Ocuton S) to 66% and 59% (NCT and HAT, respectively). Substantial inter- and intraobserver variability were observed for all tonometers.CONCLUSIONS: The NCT and HAT seem to achieve a measurement closest to the GAT. However, there was substantial variability in measurements both within and between studies.

U2 - 10.1016/j.ophtha.2012.02.030

DO - 10.1016/j.ophtha.2012.02.030

M3 - Article

C2 - 22578443

AN - SCOPUS:84864464276

SN - 0161-6420

VL - 119

SP - 1552

EP - 1557

JO - Ophthalmology

JF - Ophthalmology

IS - 8

ER -

Systematic review of the agreement of tonometers with Goldmann applanation tonometry

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