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Comparison of Intraocular Pressure Measurements in Healthy Pediatric Patients using Three Types of Tonometers.

ABSTRACT: This study aimed to compare intraocular pressure (IOP) measurements in healthy pediatric patients using three types of tonometers.Seventy-eight eyes of 78 patients under the age of 18 who underwent a routine ophthalmologic examination were included in the study. IOP was measured using Tono-Pen (TP) tonometry, Goldmann applanation tonometry (GAT), and non-contact tonometry (NCT), consecutively. IOP was adjusted based on central corneal thickness (CCT). Patients with any ocular disorders other than a limited refractive error were excluded from the study.The study consisted of 46 girls and 32 boys. The mean age was 12.6±2.7 (range: 5-17) years. The mean CCT was 559.3±35.3 µm. The mean refractive error was -0.50±1.70. The mean level of visual acuity was 0.98±0.1 (range: 0.3-1.0) using the Snellen chart. Significant differences were found between the measurement results of each of the three tonometric methods. Mean IOP was 12.1±2.2 mmHg for TP, 15.7±2.5 mmHg for GAT, and 17.1±3.1 mmHg for NCT. The correlations between measurement methods revealed that the highest correlation was between NCT and GAT (p<0.001, r=0.670). The second highest correlation was between NCT and TP (p<0.001, r=0.477). The lowest correlation was between GAT and TP (p<0.001, r=0.403). A positive correlation was found between CCT and each IOP measurement method.In pediatric patients, TP and NCT measurements were found to be positively correlated with GAT measurements. Because TP measurements were lower than GAT measurements and NCT measurements were higher than GAT measurements, patient follow-ups, treatment strategies, and surgery plans must be organized taking these differences into consideration.

SUBMITTER: Eraslan M

PROVIDER: S-EPMC5282535 | biostudies-other | 2017 Jan

REPOSITORIES: biostudies-other

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Project description:PurposeTo characterize the risk and risk factors for intraocular pressure (IOP) elevation in pediatric noninfectious uveitis.DesignMulticenter retrospective cohort study.ParticipantsNine hundred sixteen children (1593 eyes) younger than 18 years at presentation with noninfectious uveitis followed up between January 1978 and December 2007 at 5 academic uveitis centers in the United States.MethodsMedical records review by trained, certified experts.Main outcome measuresPrevalence and incidence of IOP of 21 mmHg or more and 30 mmHg or more and incidence of a rise in IOP by 10 mmHg or more. To avoid underascertainment, outcomes were counted as present when IOP-lowering therapies were in use.ResultsInitially, 251 (15.8%) and 46 eyes (2.9%) had IOP ≥21 mmHg and ≥30 mmHg, respectively. Factors significantly associated with presenting IOP elevation included age of 6 to 12 years (versus other pediatric ages), prior cataract surgery, pars plana vitrectomy, duration of uveitis ≥6 months, contralateral IOP elevation, presenting visual acuity worse than 20/40, and topical corticosteroid use (in a dose-response relationship). The median follow-up was 1.25 years (interquartile range, 0.4-3.66). The estimated incidence of any observed IOP elevation to ≥21 mmHg, to ≥30 mmHg, and increase in IOP by ≥10 mmHg was 33.4%, 14.8%, and 24.4%, respectively, within 2 years. Factors associated with IOP elevation included pars plana vitrectomy, contralateral IOP elevation (adjusted hazard ratio [aHR], up to 9.54; P < 0.001), and the use of topical (aHR, up to 8.77 that followed a dose-response relationship; P < 0.001), periocular (aHR, up to 7.96; P < 0.001), and intraocular (aHR, up to 19.7; P < 0.001) corticosteroids.ConclusionsIntraocular pressure elevation affects a large minority of children with noninfectious uveitis. Statistically significant risk factors include IOP elevation or use of IOP-lowering treatment in the contralateral eye and local corticosteroid use that demonstrated a dose-and route of administration-dependent relationship. In contrast, use of immunosuppressive drug therapy did not increase such risk. Pediatric eyes with noninfectious uveitis should be followed up closely for IOP elevation, especially when strong risk factors such as the use of local corticosteroids and contralateral IOP elevation are present.

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Comparison of Intraocular Pressure Measurements in Healthy Pediatric Patients using Three Types of Tonometers.

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