A comparative analysis of intraocular pressure measurement results by the TVGD-02 tonometer (EASYTON) and the Goldman tonometer in ethnic Asians residing in Kazakhstan

   Purpose.  To compare the results of IOP measurement by the TVGD-02 transpalpebral tonometer (EASYTON) and the Goldman to­ nometer in ethnic Asians of Kazakhstan in order to assess the influence of epicanthus on the results of transpalberal tonometry.

   Material and methods.  A total of 150 patients (150 eyes) aged 39 to 65years were examined, including 120 patients (120 eyes) with primary open-angle glaucoma (POAG), and 30 patients (30 eyes) with high astigmatism and no POAG. All patients had their (IOP) measuredfirst with a Goldman tonometer, and then with a TVGD-02 transpalpebral tonometer (EASYTON). The correlation between the two methods was determined by the Pearson correlation coefficient.

   Results.  According to the EASYTON tonometer, the average IOP over the whole group was 20.20 ± 0.45 mm Hg, whilst the respective figure for the Goldman tonometer was 19.90 ± 0.43 mm Hg, the difference being statistically insignificant (p>0.05). In both groups and in varied IOP ranges the results of Easyton and Goldman tonometer data were comparable. No peculiarities in IOP mea­ surements taken from patients with epicanthus have been revealed.  

   Conclusion.  The absence of statistically significant differences between the data obtained by EASYTON and the Goldman tonometer in Asians implies that epicanthus does not affect the results of transpalpebral tonometry. The EASYTON tonometer may be considered an effective screening device in routine clinical practice. It is easy to use and can be recommended to ophthalmologists, general practitioners, nurses, optometrists, as well as glaucoma patients for IOP monitoring at home.

1. World Health Organization. Vision Impairment and Blindness: Fact Sheet. 2014; 282 (Sept.).

2. Quigley H. A., Broman A. T. The number of people with glaucoma worldwide in 2010 and 2020. Br. J. Ophthalmol. 2006; 90 (3): 262–7. doi: 10.1136/bjo.2005.081224

3. Tham Y. C., Li X., Wong T. Y., et al. Global prevalence of glaucoma and projections of the burden of glaucoma to 2040: a systematic review and meta-analysis. Ophthalmology. 2014; 121 (11): 2081–90. doi: 10.1016/j.ophtha.2014.05.013

4. Kass M. A., Heuer D. K., Higginbotham E. J. The Ocular Hypertension Treatment Study: a randomized trial determines that topical ocular hypotensive medication delays or prevents the onset of primary open-angle glaucoma. Arch. Ophthalmol. 2002; 120 (6): 701–13. doi: 10.1001/archopht.120.6.701

5. Nytedt S., Punjabi O., Lin S., Stamper R. L. Tonometry through the ages. Surv. Ophthalmol. 2008; 53 (6): 568–91. doi: 10.1016/j.survophthal.2008.08.024

6. Goldmann H., Schmidt T. Uber Applanations tonometrie. Ophthalmologica. 1957; 134 (4): 221–42. doi: 10.1159/000303213

7. Астахов Ю. С. Аппланационная и динамическая контурная тонометрия: сравнительный анализ / Ю. С. Астахов, Е. Л. Акопов, В. В. Потемкин // Офтальмологические ведомости. – 2008. – 1: 4–10. [Astakhov Yu. S., Akopov E. L., Potemkin V. V. Applanation and contour tonometry: comparative analysis. Oftal’mologicheskie vedomosti. 2008; 1: 4–10 (In Russian)].

8. Babalola O. E., Kehinde A. V., Iloegbunam A. K., et al. Comparison of Goldman applanation tonometers and non-contact tonometers (Keeler Pulsair Easy Eye) and the effect of the thickness of the central part of the cornea on the eyes indigenous Africans. Ophthalmic Physiol Opt. 2009; 29 (2): 182–8. doi: 10.1111/j.1475-1313.2008.00621.x.

9. Mackie S. W., Jay J. L., Ackerley R., Walsh G. Clinical comparison of Keeler Pulsair 2000, American Optical MkII and Goldmann applanation blood pressure monitors. Ophthalmic Physiol. Opt. 1996; 16 (2): 171–7.

10. Yussel A. A., Sturmer J., Glur B. Comparison of tonometry with the Keeler non-contact tonometer with an air inhalation Pulsair and the Goldmann applanation tonometer. Wedge Monatsbl. Augenheilkd. 1990; 197 (4): 329–34. doi: 10.1055/s-2008-1046288

11. Moseley M. J., Evans N. M., Fielder A. R. Comparison of the new non-contact tonometer with Goldman's applanation. Eye (Lond) 1989; 3 (Pt 3): 332–7. doi: 10.1038/eye.1989.48

12. Балашевич Л. И. Влияние толщины роговицы на пневмотонометрические показатели внутриглазного давления / Л. И. Балашевич [и др.] // Офтальмохирургия. – 2005. – 1: 31–3. [Balashevich L. I., Kachanov A. B., Nikulin S. A., et al. Influence of corneal thickness on pneumotonometric indicators of intraocular pressure. Ophthalmosurgery. 2005; 1: 31–3 (in Russian)].

13. Harada Y., Hirose N., Kubota T., Tawara A. The influence of central corneal thickness and corneal curvative radius on the intraocular pressure as measured by different tonometers: noncontact and Goldmann applanation tonometers. J. Glaucoma. 2008; 17 (8): 619–25. doi: 10.1097/IJG.0b013e3181634f0f

14. Макашова Н. В. Клинические результаты транспальпебральной тонометрии / Н. В. Макашова, К. В. Иванищев // Глаукома. – 2013. – 2: 42–6. [Makashova N. V., Ivanishchev K. V. Clinical results of transpalpebral tonometry. Glaucoma. 2013; 2: 42–6 (in Russian)].

15. Тугеева Э. Э. Возможности применения транспальпебрального тонометра ТВГД-01 в детской офтальмологической практике / Э. Э. Тугеева, Т. Н. Воронцова // РМЖ. Клиническая офтальмология. – 2013. – 13 (2): 61–3. [Tugeeva E. E., Vorontsova T. N. Possibilities of using the TVGD-01 transpalpebral tonometer in pediatric ophthalmological practice. RMJ. Clinical ophthalmology. 2013; 13 (2): 61–3 (in Russian)].

16. Тугеева Э. Э. Влияние основных параметров фиброзной капсулы на результаты различных способов офтальмотонометрии у детей / Э. Э. Тугеева [и др.] // Российская педиатрическая офтальмология. – 2015. – 2: 38–40. [Tugeeva E. E., Vorontsova T. N., Brzheskiy V. V., Zaitseva M. V. Influence of the main parameters of the fibrous capsule on the results of various methods of ophthalmotonometry in children. Russian pediatric ophthalmology. 2015; 2: 38–40 (in Russian)].

17. Кушнаревич Н. Ю. Оценка точности и информативности измерения внутриглазного давления с помощью транспальпебральной тонометрии у пациентов в контактных линзах / Н. Ю. Кушнеревич [и др.] // Российский офтальмологический журнал. – 2020. – 13 (2): 23–8. [Kushnarevich N. Yu., Iomdina E. N., Bessmertny A. M., Kuzin M. N. Estimation of the accuracy and informativeness of measuring intraocular pressure in patients with their contact lenses on by transpalpebral scleral tonometry. Russian ophthalmological journal. 2020; 13 (2): 23–8 (in Russian)]. https://doi.org/10.21516/2072-0076-2020-13-2-23-28

18. Wang D., Huang W., Li Y., et al. Intraocular pressure, central corneal thickness and glaucoma in Chinese adults: a study of the Liwan eye. Am. J. Ophthalmol. 2011; 152 (3): 454–62. E 1. doi: 10.1016/j.ajo.2011.03.005

19. Shimmö M., Ross A. J., Moy A., Mostafavi R. Intraocular pressure, Goldmann applanation tension, corneal thickness and corneal curvature in Caucasians, Asians, Hispanics and African Americans. Am. J. Ophthalmol. 2003; 136 (4): 603–13. doi: 10.1016/s0002-9394(03)00424-0

20. Nomura H., Ando F., Niino N., Shimokata H., Miyake Y. The relationship between age and intraocular pressure in the Japanese population: the effect of central corneal thickness. Curr. Eye Res. 2002; 24 (2): 81–5. doi: 10.1076/ceyr.24.2.81.8161

21. Gupta V., Sonya P., Agarwal H. K., Sikhota R., Sharma A. Interinstrumental agreement and influence of central corneal thickness on measurements with Goldman, pneumotonometer and non-contact tonometer in glaucomatous eyes. Indian J. Ophthalmol. 2006; 54 (4): 261–5. doi: 10.4103/0301-4738.27952

22. Santos M. G., Mack S., Berghold A., Eckhard M., Haas A. Difference in intraocular pressure with Goldman's applanation tonometry compared to the manual Perkins applanation tonometer in overweight patients. Ophthalmology. 1998; 105 (12): 2260–3. doi: 10.1016/S0161-6420(98)91226-X

23. Moses R. A. Fluorescein in applanation tonometry. Am. J. Ophthalmol. 1960; 49: 1149–55. doi: 10.1016/0002-9394(60)91627-5

24. Илларионова А. Р. Транспальпебральная тонометрия в клинической практике / А. Р. Илларионова, Б. В. Обруч // Окулист. – 2003. – 2: 42. [Illarionova A. R., Hoop B. V. Transpalpebral tonometry in clinical practice. Oculist. 2003; 2: 42 (In Russian)].

25. Филиппова О. М. Перспективы применения тонометра ТВГД-02 для ассистированного мониторинга внутриглазного давления в домашней практике / О. М. Филиппова [и др.] // Российский офтальмологический журнал. – 2021. – 14 (2): 27–35. [Filippova O. M., Bessmertny A. M., Kuzin M. N., Petrov S. Yu. Prospects of using the TVGD-02 tonometer for assisted monitoring of intraocular pressure at home. Russian ophthalmological journal. 2021; 14 (2): 27–35 (In Russian)]. https://doi.org/10.21516/2072-0076-2021-14-2-27-35

26. Илларионова А. Р. Исследование достоверности показаний тонометра для измерения внутриглазного давления через веко (ТГДц-01 «ПРА») / А. Р. Илларионова, Н. Г. Пилецкий // РМЖ. Клиническая офтальмология. – 2001. – 2: 55–6. [Illarionova A. R., Piletsky N. G. Study of the reliability of the tonometer readings for measuring intraocular pressure through the eyelid (TGDts-01 "PRA"). RMJ. Clinical ophthalmology. 2001; 2: 55–6 (in Russian)].

27. Филиппова О. М. Транспальпебральная тонометрия: новые возможности регистрации внутриглазного давления / О. М. Филиппова // Глаукома. – 2004. – 1: 35–8. [Filippova O. M. Transpalpebral tonometry: new possibilities for registering intraocular pressure. Glaucoma. 2004; 1: 35–8 (in Russian)].

28. Колесникова М. А. Оценка достоверности показаний транспальпебрального индикатора внутриглазного давления ТГД-02 «ПРА» / М. А. Колесникова [и др.] // Офтальмохирургия. – 2002/ – 3: 45–7. [Kolesnikova M. A., Kunin V. D., Mironenko L. V., et al. Evaluation of the reliability of the indications of the transpalpebral indicator of intraocular pressure IGD "PRA". Ophthalmosurgery. 2002; 3: 45–7 (in Russian)].

29. Тугеева Э. Э. Возможности применения транспальпебрального тонометра ТВГД-01 в детской офтальмологической практике / Э. Э. Тугеева, Т. Н. Воронцова // РМЖ. Клиническая Офтальмология. – 2013. – 13 (2): 61–3. [Tugeeva E. E., Vorontsova T. N. Possibilities of using the TVGD-01 transpalpebral tonometer in pediatric ophthalmological practice. RMJ. Clinical ophthalmology. 2013; 13 (2): 61–3 (in Russian)].