The Clinical Interpretation of Changes in Intraocular Pressure Measurements Using Goldmann Applanation Tonometry: A Review

dc.contributor.authorPearce, John
dc.contributor.authorMaddess, Ted
dc.date.accessioned2022-11-24T23:16:12Z
dc.date.issued2019
dc.date.updated2021-11-28T07:29:37Z
dc.description.abstractThe interpretation of changes in serial intraocular pressure (IOP) measurements are critical in the diagnosis and management of glaucoma. Differentiating true change from test-retest variability (TRV) in IOP measurements using Goldmann applanation tonometry (IOPG) is essential when reviewing these measurements. We, therefore, determine clinically applicable guidelines for differentiating TRV from the true change in IOPG by quantitatively summarizing the published evidence from 18 studies. Methods: Studies reporting TRV in clinically meaningful ways, such as the coefficient of repeatability or the limits of agreement, were collated and analyzed. A single linear model quantitatively summarized the TRV for the commonly encountered combinations of patient types and intraobserver versus interobserver testing. The best model determined n-fold effects providing asymmetric SEs. Results: For the common intraobserver/interobserver visit combination the model results for healthy subjects and glaucoma/ocular hypertensive patients were TRV (±SE) values of 3.16 (2.67 to 3.74) and 4.26 (3.12 to 5.84) mm Hg, respectively. For the interobserver/intervisit case for glaucoma/ocular hypertension patients, the estimated TRV was 5.50 (3.43 to 8.76) mm Hg, for which no published coefficient of repeatability or limits of agreement data exists at present. The overall model was significant at P<0.018. Conclusions: Potential improvements in the diagnosis and management of glaucoma are made by providing clinicians with well-estimated values for TRV in IOPG derived from the evidence base. These values not only enable individual clinicians to better interpret changes in IOPG, but they also provide a basis for standardizing the interpretation of changes in IOPG between clinics, clinicians, and patient types.en_AU
dc.format.mimetypeapplication/pdfen_AU
dc.identifier.issn1057-0829en_AU
dc.identifier.urihttp://hdl.handle.net/1885/280416
dc.language.isoen_AUen_AU
dc.publisherLippincott Williams & Wilkinsen_AU
dc.rights© 2018 The authorsen_AU
dc.sourceJournal of Glaucomaen_AU
dc.subjectGoldmann applanation tonometryen_AU
dc.subjectintraocular pressureen_AU
dc.subjecttest-retest variabilityen_AU
dc.subjectglaucomaen_AU
dc.titleThe Clinical Interpretation of Changes in Intraocular Pressure Measurements Using Goldmann Applanation Tonometry: A Reviewen_AU
dc.typeJournal articleen_AU
local.bibliographicCitation.issue4en_AU
local.bibliographicCitation.lastpage306en_AU
local.bibliographicCitation.startpage302en_AU
local.contributor.affiliationPearce, John, College of Health and Medicine, ANUen_AU
local.contributor.affiliationMaddess, Ted, College of Health and Medicine, ANUen_AU
local.contributor.authoremailu8103614@anu.edu.auen_AU
local.contributor.authoruidPearce, John, u5081346en_AU
local.contributor.authoruidMaddess, Ted, u8103614en_AU
local.description.embargo2099-12-31
local.description.notesImported from ARIESen_AU
local.identifier.absfor321201 - Ophthalmologyen_AU
local.identifier.absfor321203 - Optometryen_AU
local.identifier.absseo280112 - Expanding knowledge in the health sciencesen_AU
local.identifier.absseo200101 - Diagnosis of human diseases and conditionsen_AU
local.identifier.ariespublicationu3102795xPUB1391en_AU
local.identifier.citationvolume28en_AU
local.identifier.doi10.1097/IJG.0000000000001144en_AU
local.identifier.scopusID2-s2.0-85057595031
local.identifier.uidSubmittedByu3102795en_AU
local.publisher.urlhttps://journals.lww.com/en_AU
local.type.statusPublished Versionen_AU

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