Subscribe to RSS
DOI: 10.1055/s-0029-1246053
© Georg Thieme Verlag KG Stuttgart · New York
Messverfahren der Tonometrie
Techniques of Intraocular Pressure MeasurementPublication History
Eingegangen: 10.12.2010
Angenommen: 19.1.2011
Publication Date:
15 February 2011 (online)
Zusammenfassung
Die korrekte Interpretation tonometrischer Messwerte in der Augenheilkunde ist in den letzten Jahren immer komplexer geworden. Große klinische Untersuchungen hatten zunächst gezeigt, dass in der Bevölkerung die mittlere zentrale Hornhautdicke bei 550 µm anzunehmen ist. Da jedoch die valide Applanationstonometrie von Goldmann auf eine zentrale HH-Dicke von 520 µm ausgelegt ist, werden mathematische Korrekturformeln zur Berechnung des angenommenen wahren Augeninnendrucks diskutiert. Neuere Tonometrieverfahren, wie z. B. die dynamische Konturtonometrie, wurden entwickelt, um das physikalische Problem der Hornhautdicke zu umgehen. Das zusätzliche Inbetrachtziehen viskoelastischer Eigenschaften der Hornhaut, wie dies mit der kornealen Hysterese und dem kornealen Resistenzfaktor bei der Tonometrie mit dem Ocular Response Analyzer in die Messung miteinbezogen wird, unterstreicht die Komplexizität der modernen Tonometrie. Ziel dieses Beitrags ist es, die derzeit gebräuchlichen Messverfahren vorzustellen und in ihrer klinischen Bedeutung einzuordnen.
Abstract
The correct interpretation of measured tonometric values has become more and more complex in recent years. Large clinical studies have shown that an average central corneal thickness (CCT) of 550 µm can be assumed for the general population. Since the standard Glodmann applanation tonometry is based on a central corneal thickness of 520 µm, mathematical correction formula have been discussed for calculation of the true intraocular pressure. Newer tonometry devices, e. g. the dynamic contour tonometry (DCT) which seems to be independent from CCT, or the Ocular Response Analyzer® (ORA), taking into account the biomechanical properties of the cornea, have been designed to measure intraocular pressure (IOP). In this article, several IOP measurement devices and their clinical relevance for a correct and feasible determination of the IOP are discussed.
Schlüsselwörter
Glaukom - intraokularer Druck - Goldmann-Applanationstonometrie - dynamische Konturtonometrie - Ocular Reponse Analyzer
Key words
glaucoma - intraocular pressure - Goldmann applanation tonometry - dynamic contour tonometry - Ocular Reponse Analyzer
Literatur
- 1 Goldmann H, Schmidt T. Applanation tonometry. Ophthalmologica. 1957; 134 (4) 221-242
- 2 Copt R P, Thomas R, Mermoud A. Corneal thickness in ocular hypertension, primary open-angle glaucoma, and normal tension glaucoma. Arch Ophthalmol. 1999; 117 (1) 14-16
- 3 Herndon L W, Choudhri S A, Cox T et al. Central corneal thickness in normal, glaucomatous, and ocular hypertensive eyes. Arch Ophthalmol. 1997; 115 (9) 1137-1141
- 4 Morad Y, Sharon E, Hefetz L et al. Corneal thickness and curvature in normal-tension glaucoma. Am J Ophthalmol. 1998; 125 (2) 164-168
- 5 Ventura A C, Böhnke M, Mojon D S. Central corneal thickness measurements in patients with normal tension glaucoma, primary open angle glaucoma, pseudoexfoliation glaucoma, or ocular hypertension. Br J Ophthalmol. 2001; 85 (7) 792-795
- 6 Wolfs R C, Klaver C C, Vingerling J R et al. Distribution of central corneal thickness and its association with intraocular pressure: The Rotterdam Study. Am J Ophthalmol. 1997; 123 (6) 767-772
- 7 Shah S. Accurate intraocular pressure measurement-the myth of modern ophthalmology?. Ophthalmology. 2000; 107 (10) 1805-1807
- 8 Kohlhaas M, Boehm A G, Spoerl E et al. Effect of central corneal thickness, corneal curvature, and axial length on applanation tonometry. Arch Ophthalmol. 2006; 124 (4) 471-476
- 9 Medeiros F A, Sample P A, Zangwill L M et al. Corneal thickness as a risk factor for visual field loss in patients with preperimetric glaucomatous optic neuropathy. Am J Ophthalmol. 2003; 136 (5) 805-813
- 10 Herndon L W, Weizer J S, Stinnett S S. Central corneal thickness as a risk factor for advanced glaucoma damage. Arch Ophthalmol. 2004; 122 (1) 17-21
- 11 Frenkel R E, Hong Y J, Shin D H. Comparison of the Tono-Pen to the Goldmann applanation tonometer. Arch Ophthalmol. 1988; 106 (6) 750-753
- 12 Simon G, Small R H, Ren Q et al. Effect of corneal hydration on Goldmann applanation tonometry and corneal topography. Refractive & Corneal Surgery. 1993; 9 (2) 110-117
- 13 Kamppeter B A, Jonas J B. Dynamic contour tonometry for intraocular pressure measurement. Am J Ophthalmol. 2005; 140 (2) 318-320
- 14 Kaufmann C, Bachmann L M, Thiel M A. Comparison of dynamic contour tonometry with goldmann applanation tonometry. Invest Ophthalmol Vis Sci. 2004; 45 (9) 3118-3121
- 15 Kotecha A, White E T, Shewry J M et al. The relative effects of corneal thickness and age on Goldmann applanation tonometry and dynamic contour tonometry. Br J Ophthalmol. 2005; 89 (12) 1572-1575
- 16 Schneider E, Grehn F. Intraocular pressure measurement-comparison of dynamic contour tonometry and goldmann applanation tonometry. J Glaucoma. 2006; 15 (1) 2-6
- 17 Siganos D S, Papastergiou G I, Moedas C. Assessment of the Pascal dynamic contour tonometer in monitoring intraocular pressure in unoperated eyes and eyes after LASIK. J Cataract Refract Surg. 2004; 30 (4) 746-751
- 18 Barleon L, Hoffmann E M, Berres M et al. Comparison of dynamic contour tonometry and goldmann applanation tonometry in glaucoma patients and healthy subjects. Am J Ophthalmol. 2006; 142 (4) 583-590
- 19 Martinez-de-la-Casa J M, Garcia-Feijoo J, Vico E et al. Effect of corneal thickness on dynamic contour, rebound, and goldmann tonometry. Ophthalmology. 2006; 113 (12) 2156-2162
- 20 Iliev M E, Goldblum D, Katsoulis K et al. Comparison of rebound tonometry with Goldmann applanation tonometry and correlation with central corneal thickness. Br J Ophthalmol. 2006; 90 (7) 833-835
- 21 Davies L N, Bartlett H, Mallen E AH et al. Clinical evaluation of rebound tonometer. Acta Ophthalmol Scand. 2006; 84 (2) 206-209
- 22 Martinez-de-la-Casa J M, Garcia-Feijoo J, Castillo A et al. Reproducibility and clinical evaluation of rebound tonometry. Invest Ophthalmol Vis Sci. 2005; 46 (12) 4578-4580
- 23 Kontiola A, Puska P. Measuring intraocular pressure with the Pulsair 3000 and Rebound tonometers in elderly patients without an anesthetic. Graefes Arch Clin Exp Ophthalmol. 2004; 242 (1) 3-7
- 24 Brusini P, Salvetat M L, Zeppieri M et al. Comparison of ICare tonometer with Goldmann applanation tonometer in glaucoma patients. J Glaucoma. 2006; 15 (3) 213-217
- 25 Jordan J F, Dietlein T S, Dinslage S et al. New aspects of corneal pachymetry in congenital glaucoma and pediatric aphakic glaucoma. Klin Monatsbl Augenheilkd. 2005; 222 (11) 883-887
- 26 Henriques M J, Vessani R M, Reis F AC et al. Corneal thickness in congenital glaucoma. J Glaucoma. 2004; 13 (3) 185-188
- 27 Amino K, Miyahara S, Tanihara H. Corneal thickness in eyes following pars plana lensectomy for congenital cataracts. Jpn J Ophthalmol. 2004; 48 (2) 169-171
- 28 Brandt J D, Casuso L A, Budenz D L. Markedly increased central corneal thickness: an unrecognized finding in congenital aniridia. Am J Ophthalmol. 2004; 137 (2) 348-350
- 29 Yücel A A, Stürmer J, Gloor B. Comparison of tonometry with the Keeler air puff non-contact tonometer „Pulsair” and the Goldmann applanation tonometer. Klin Monatsbl Augenheilkd. 1990; 197 (4) 329-334
- 30 Domke N, Hager A, Wiegand W. Intraocular pressure and corneal thickness. A comparison between non-contact tonometry and applanation tonometry. Ophthalmologe. 2006; 103 (7) 583-587
- 31 Tonnu P, Ho T, Newson T et al. The influence of central corneal thickness and age on intraocular pressure measured by pneumotonometry, non-contact tonometry, the Tono-Pen XL, and Goldmann applanation tonometry. Br J Ophthalmol. 2005; 89 (7) 851-854
- 32 Armstrong T A. Evaluation of the Tono-Pen and the Pulsair tonometers. Am J Ophthalmol. 1990; 109 (6) 716-720
- 33 Lawson-Kopp W, DeJong A, Yudcovitch L et al. Clinical evaluation of the Keeler Pulsair 3000 non-contact tonometer. Optometry. 2002; 73 (2) 81-90
- 34 Luce D A. Determining in vivo biomechanical properties of the cornea with an ocular response analyzer. J Cataract Refract Surg. 2005; 31 (1) 156-162
- 35 Broman A T, Congdon N G, Bandeen-Roche K et al. Influence of corneal structure, corneal responsiveness, and other ocular parameters on tonometric measurement of intraocular pressure. J Glaucoma. 2007; 16 (7) 581-588
- 36 Martinez-de-la-Casa J M, Garcia-Feijoo J, Fernandez-Vidal A et al. Ocular response analyzer versus Goldmann applanation tonometry for intraocular pressure measurements. Invest Ophthalmol Vis Sci. 2006; 47 (10) 4410-4414
- 37 Hager A, Schroeder B, Sadeghi M et al. The influence of corneal hysteresis and corneal resistance factor on the measurement of intraocular pressure. Der Ophthalmologe. 2007; 104 (6) 484-489
- 38 Kotecha A, Elsheikh A, Roberts C R et al. Corneal thickness- and age-related biomechanical properties of the cornea measured with the ocular response analyzer. Invest Ophthalmol Vis Sci. 2006; 47 (12) 5337-5347
- 39 Congdon N G, Broman A T, Bandeen-Roche K et al. Central corneal thickness and corneal hysteresis associated with glaucoma damage. Am J Ophthalmol. 2006; 141 (5) 868-875
- 40 Sun L, Shen M, Wang J et al. Recovery of corneal hysteresis after reduction of intraocular pressure in chronic primary angle-closure glaucoma. Am J Ophthalmol. 2009; 147 (6) 1061 – 1066, 1066.e1-1066.2
- 41 Shimmyo M. Recovery of corneal hysteresis after reduction of intraocular pressure in chronic primary angle-closure glaucoma. Am J Ophthalmol. 2009; 148 (4) 623
- 42 Neuburger M, Böhringer D, Reinhard T et al. Recovery of corneal hysteresis after reduction of intraocular pressure in chronic primary angle-closure glaucoma. Am J Ophthalmol. 2010; 149 (4) 687-688
- 43 Rai S, Moster M R, Kesen M et al. Level of disagreement between Proview phosphene tonometer and Goldmann applanation tonometer intraocular pressure readings. J Glaucoma. 2005; 14 (2) 120-123
- 44 Alvarez T L, Gollance S A, Thomas G A et al. The Proview phosphene tonometer fails to measure ocular pressure accurately in clinical practice. Ophthalmology. 2004; 111 (6) 1077-1085
- 45 Li J, Herndon L W, Asrani S G et al. Clinical comparison of the Proview eye pressure monitor with the Goldmann applanation tonometer and the Tonopen. Archives of Ophthalmology. 2004; 122 (8) 1117-1121
- 46 Rombold F, Thiel M J, Neubauer A S et al. [Evaluation of portable TGDc-01 tonometers and comparison with the Goldmann applanation tonometer]. Der Ophthalmologe. 2005; 102 (2) 158-162
- 47 Schlote T, Landenberger H. Intraocular pressure difference in Goldmann applanation tonometry versus a transpalpebral tonometer TGDc-01„PRA” in glaucoma patients. Klin Monatsbl Augenheilkd. 2005; 222 (2) 123-131
- 48 Troost A, Specht K, Krummenauer F et al. Deviations between transpalpebral tonometry using TGDc-01 and Goldmann applanation tonometry depending on the IOP level. Graefes Arch Clin Exp Ophthalmol. 2005; 243 (9) 853-858
- 49 Meyer M W, Gockeln R, Hoy L et al. Comparison of intraocular pressure measurements with the digital tonometer TGDc-01 ‘PRA’ and the Goldmann applanation tonometer. Ophthalmic Research. 2004; 36 (5) 250-254
- 50 Hallberg P, Lindén C, Lindahl O A et al. Applanation resonance tonometry for intraocular pressure in humans. Physiological Measurement. 2004; 25 (4) 1053-1065
- 51 Hallberg P, Eklund A, Bäcklund T et al. Clinical evaluation of applanation resonance tonometry: a comparison with Goldmann applanation tonometry. Journal of Glaucoma. 2007; 16 (1) 88-93
- 52 Eklund A, Hallberg P, Lindén C et al. An applanation resonator sensor for measuring intraocular pressure using combined continuous force and area measurement. Investigative Ophthalmology & Visual Science. 2003; 44 (7) 3017-3024
- 53 Leonardi M, Leuenberger P, Bertrand D et al. First steps toward noninvasive intraocular pressure monitoring with a sensing contact lens. Invest Ophthalmol Vis Sci. 2004; 45 (9) 3113-3117
- 54 Hediger A, Kniestedt C, Zweifel S et al. Continuous intraocular pressure measurement: First results with a pressure-sensitive contact lens. Der Ophthalmologe. 2009; 106 (12) 1111-1115
Dr. Matthias Neuburger
Augenklinik, Universitätsklinik Freiburg
Killianstr. 5
79106 Freiburg
Phone: ++ 49/7 61/2 70 40 01
Fax: ++ 49/7 61/2 70 41 27
Email: matthias.neuburger@uniklinik-freiburg.de