Evaluation of the Effect of Body Position on Intraocular Pressure Measured with Rebound Tonometer

Objectives:It is important to determine variables that influence intraocular pressure (IOP) measurement. This study aimed to evaluate the effect of body position on IOP.Materials and Methods:The study included 52 right eyes of 52 patients who presented to the ophthalmology department of our hospital and had no ocular disease except refractive errors. IOP was measured with an Icare PRO tonometer while patients were in sitting, standing, and supine positions, with intervals of 10 minutes between the positions. Correlations between the results were evaluated using Spearman’s correlation analysis and Wilcoxon tests.Results:Thirty-six of the 52 patients were female, 16 were male. Mean age was 31.65±6.30 (23-47) years. Mean IOP values in the sitting, standing, and lying positions were 17.76±3.41 (12.70-25.60) mmHg, 17.10±3.27 (11.50-25.20) mmHg, and 18.46±4.67 (10.50-29.40) mmHg, respectively. There were no statistically significant differences between measurements taken in the different positions (p=0.112, p=0.472, p=0.071). We observed that there was no relationship between age and body position (p>0.45, p>0.79, p>0.77) or between gender and position (p>0.59, p>0.69, p>0.54).Conclusion:Gender and age had no effect on IOP measured in different body positions. There were also no significant differences between IOP values measured in the different positions. Therefore, we believe the portable Icare PRO tonometer can be used for patients who are confined to bed and will provide IOP measurements that are concordant with values obtained while sitting

Comparison of Diagnostic Accuracy of MRA and GPS Algorithms Using HR III Device in Glaucoma Patients

Objectives: The aim of this study is to evaluate the diagnostic accuracy of Moorfields regression analysis (MRA) and glaucoma probability score (GPS) and to measure the agreement between these two programs in classifying eyes as normal or abnormal. Materials and Methods: The study included 150 glaucoma patients followed in our glaucoma unit and 120 control subjects without glaucoma. All subjects underwent total ophthalmological examination, standard achromatic perimetry, and imaging of the optic nerve head with the Heidelberg Retina Tomograph II (HRT), using HRT III software, Version 3.0. The HRT parameters were compared between the two groups. The diagnostic accuracies of the two classifications were measured when the borderline was taken as either normal (highest specificity criteria) or abnormal (highest sensitivity criteria). The agreement between them was calculated using the kappa (κ) coefficient. Results: All HRT parameters except height variation contour in our study showed statistically differences between the control and glaucoma groups (p=0.000). The parameters with the highest area under curves were GPS global score (0.817), vertical cup/disc ratio (0.816), cup/disc area (0.808), and cup area (0.783). According to the highest specificity criteria, MRA had a sensitivity of 66% and specificity of 89.1% and GPS had a sensitivity of 62.7% and specificity of 81.6%. According to the highest sensitivity criteria, MRA had a sensitivity of 85.3% and specificity of 68.3% and GPS had a sensitivity of 90% and specificity of 60.8%. A moderate agreement of 65.9% (178 eyes) with a κ coefficient of 0.47 was found between MRA and GPS. Conclusion: In conclusion, GPS and MRA had a similar sensitivity, but the specificity of MRA was found to be higher than that of GPS. A moderate agreement was found between these analysis programs. (Turk J Ophthalmol 2014; 44: 108-114