Ocular Response Analyzer in subjects with and without glaucoma.
OBJECTIVE
The Ocular Response Analyzer (ORA) is a newly introduced tonometer that uniquely measures and then integrates corneal biomechanical data into its intraocular pressure (IOP) estimates in an effort to improve accuracy of IOP assessment. This study was devised to investigate whether ORA-derived IOP and corneal biomechanical variables might be useful in discriminating between subjects with and without primary open-angle glaucoma (GLC).


METHODS
All patients seen in the Albuquerque VAMC eye clinic over a 10-week period who demonstrated acceptable ORA signal profiles were retrospectively identified. In subjects classified as normal (NML), ocular hypertension (OH), glaucoma suspect (GS), and GLC, the following variables were compared: age, ethnicity, Goldmann IOP, central corneal thickness (CCT), and ORA-derived data: Goldmann-correlated IOP (IOPg), corneal-compensated IOP (IOPcc), corneal resistance factor (CRF), corneal hysteresis (CH), and difference between IOPcc and IOPg (DIOP; IOPcc - IOPg).


RESULTS
Right eyes in 71 NML, 58 OH, 70 GS, and 99 GLC subjects were studied. Using analysis of variance, higher mean age, higher mean DIOP, and lower mean CH were found in the GLC group compared with OH, GS, and NML groups. In multivariate regression analyses, factors that independently discriminated between groups were: age, IOPcc, and DIOP (GLC vs. NML); age and IOPcc (GLC vs. GS); age and CRF (GLC vs. OH). When DIOP was left out of the models, CH replaced DIOP in the GLC vs. NML analysis with nearly equal statistical power.


CONCLUSIONS
Our results suggest that ORA-generated parameters may be useful for differentiating subjects with and without GLC. Furthermore, the discriminatory power of each ORA variable seems to depend on the diagnostic groups that are being compared. Finally, our findings also suggest that measured IOP may be significantly underestimated in glaucoma patients compared with non-glaucoma patients.
Albuquerque VA Medical Center, Albuquerque, New Mexico 87108, USA. Michael.Sullivan-Mee@med.va.gov
Michael
M
Sullivan-Mee
Shavon C
SC
Billingsley
Amita D
AD
Patel
Kathy D
KD
Halverson
Brooks R
BR
Alldredge
Clifford
C
Qualls
D000704:Analysis of Variance; D003315:Cornea / Q000502:physiology* / Q000503:physiopathology*; D003941:Diagnostic Techniques, Ophthalmological; D005901:Glaucoma / Q000473:pathology / Q000503:physiopathology*; D006801:Humans; D007429:Intraocular Pressure; D012016:Reference Values