title: Assessment of IcareONE rebound tonometer for self-measuring intraocular pressure.
abstract: OBJECTIVE
  To evaluate the precision of the IcareONE rebound tonometer, which was developed for self-measuring intraocular pressure (IOP) and to compare IcareONE measurement with Goldmann applanation tonometry (GAT).
  
  
  METHODS
  Twenty-four healthy eyes and 81 glaucomatous eyes were enrolled. IOP measurements (three times per session) with IcareONE were made in a random order by an ophthalmologist (Icare(O)) and by the subject (Icare(S)). Intraclass correlation coefficients (CCs), kappa values and mean values of IOP were compared among the two types of Icare recordings and GAT. Bland-Altman analysis was used to assess agreement between methods. Multiple regression analysis was performed to identify the subject factors that influenced the discordant measurements between IcareONE and GAT.
  
  
  RESULTS
  The mean value of Icare(O) and Icare(S) measurements was 13.5±5.2 and 13.5±5.4 mmHg, respectively, neither of which was significantly different from GAT (13.8±4.4). The intrarater CC of Icare(O) and Icare(S) was 0.968 and 0.885, respectively. The intermethod CC and weighted kappa between Icare(O) and Icare(S) were 0.907 and 0.684, respectively. All pairwise correlations between the two types of IOP measurement showed coefficients of determination >0.8. Bland-Altman analysis did not show any proportional biases. Multiple regression analysis revealed that the differences between GAT and Icare(O) or Icare(S) were positively correlated with central corneal thickness (CCT) and negatively correlated with age.
  
  
  CONCLUSIONS
  Intraocular pressure measurements with IcareONE by a physician and by the subject showed excellent agreement with GAT measurements; IcareONE measurements between a physician and the subject had high intrarater reliability, and good agreement thicker CCT led IcareONE measurement to overestimate IOP, while higher age caused it to underestimate IOP compared with GAT.
authors.affiliation: Division of Ophthalmology, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: Mari
authors.initials: M
authors.lastname: Sakamoto
authors.forename: Akiyasu
authors.initials: A
authors.lastname: Kanamori
authors.forename: Masashi
authors.initials: M
authors.lastname: Fujihara
authors.forename: Yuko
authors.initials: Y
authors.lastname: Yamada
authors.forename: Makoto
authors.initials: M
authors.lastname: Nakamura
authors.forename: Akira
authors.initials: A
authors.lastname: Negi
mesh_terms: D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D005901:Glaucoma / Q000175:diagnosis* / Q000503:physiopathology; D006801:Humans; D007429:Intraocular Pressure; D008297:Male; D008875:Middle Aged; D009798:Ocular Hypertension / Q000175:diagnosis* / Q000503:physiopathology; D011446:Prospective Studies; D015203:Reproducibility of Results; D012648:Self Care / Q000379:methods*; D014065:Tonometry, Ocular / Q000295:instrumentation*; D055815:Young Adult
keywords: IcareONE; intraocular pressure; rebound tonometer; self-measurements