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Reproducibility and clinical relevance of the ocular response analyzer in nonoperated eyes: corneal biomechanical and tonometric implications.

Abstract：

PURPOSE:To assess the reproducibility of the ocular response analyzer (ORA) in nonoperated eyes and the impact of corneal biomechanical properties on intraocular pressure (IOP) measurements in normal and glaucomatous eyes. METHODS:In the reliability study, two independent examiners obtained repeated ORA measurements in 30 eyes. In the clinical study, the examiners analyzed ORA and IOP-Goldmann values from 220 normal and 42 glaucomatous eyes. In both studies, Goldmann-correlated IOP measurement (IOP-ORAg), corneal-compensated IOP (IOP-ORAc), corneal hysteresis (CH), and corneal resistance factor (CRF) were evaluated. IOP differences of 3 mm Hg or greater between the IOP-ORAc and IOP-ORAg were considered outcome significant. RESULTS:Intraexaminer intraclass correlation coefficients and interexaminer concordance correlation coefficients ranged from 0.78 to 0.93 and from 0.81 to 0.93, respectively, for all parameters. CH reproducibility was highest, and the IOP-ORAg readings were lowest. The median IOP was 16 mm Hg with the Goldmann tonometer, 14.5 mm Hg with IOP-ORAg (P < 0.001), and 15.7 mm Hg with IOP-ORAc (P < 0.001). Outcome-significant results were found in 77 eyes (29.38%). The IOP-ORAc, CH, and CRF were correlated with age (r = 0.22, P = 0.001; r = -0.23, P = 0.001; r = -0.14, P = 0.02, respectively), but not the IOP-ORAg or IOP-Goldmann. CONCLUSIONS:The ORA provides reproducible corneal biomechanical and IOP measurements in nonoperated eyes. Considering the effect of ORA, corneal biomechanical metrics produces an outcome-significant IOP adjustment in at least one quarter of glaucomatous and normal eyes undergoing noncontact tonometry. Corneal viscoelasticity (CH) and resistance (CRF) appear to decrease minimally with increasing age in healthy adults.

journal_name

Invest Ophthalmol Vis Sci

journal_title

Investigative ophthalmology & visual science

authors

Moreno-Montañés J,Maldonado MJ,García N,Mendiluce L,García-Gómez PJ,Seguí-Gómez M

doi

10.1167/iovs.07-0280

subject

Has Abstract

pub_date

2008-03-01 00:00:00

pages

968-74

issue

eissn

0146-0404

issn

1552-5783

pii

49/3/968

journal_volume

pub_type

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Reproducibility and clinical relevance of the ocular response analyzer in nonoperated eyes: corneal biomechanical and tonometric implications.