title: Agreement between diurnal variations of intraocular pressure by Tono-Pen and Goldmann applanation tonometer in patients on topical anti-glaucoma medication.
abstract: To estimate agreement in diurnal variations of intraocular pressure (IOP) by Tono-Pen (TP) and Goldmann applanation tonometer (GAT) in glaucoma patients on topical anti-glaucoma medication(s). IOP was measured at every 3 h from 7 a.m. to 10 a.m. in 50 eyes of glaucoma patients on topical medication(s). Diurnal fluctuation of IOP by each method was calculated as maximum-minimum IOP in a day. Central corneal thickness (CCT) was measured by ultrasonic pachymeter. There was good correlation between TP and GAT at all times during a day, minimum, and maximum IOPs during a day (Correlation coefficient, 0.706 at 7 a.m., 0.624 at 10 a.m., 0.682 at 1 p.m., 0.814 at 4 p.m., 0.652 at 7 p.m., 0.572 at 10 p.m., 0.668 minimum IOP, 0.689 maximum IOP). Mean IOPs by TP were always higher than GAT at all times during a day. Bland-Altman plots suggested a close relationship between the two sets of readings, and that this relationship was consistent at different times in a day, in maximum IOPs, minimum IOPs and also in fluctuation of IOPs. Linear regression analysis between the differences of diurnal fluctuation (diurnal fluctuation by GAT-diurnal fluctuation by TP) and CCT showed strong association (R 2 = 0.857, p < 0.001). The mean change in difference of diurnal fluctuation (GAT-TP) for a 10-micron increase in CCT was 0.69 mmHg. TP can be considered a reliable alternative to GAT in glaucoma patients for knowing the diurnal control of IOP; however these two methods should not be used interchangeably. Difference of diurnal fluctuation between two methods is dependent on CCT.
authors.affiliation: Dr Rajendra Prasad Center for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, 110029, India.
authors.forename: Shikha
authors.initials: S
authors.lastname: Gupta
authors.affiliation: Dr Rajendra Prasad Center for Ophthalmic Sciences, All India Institute of Medical Sciences, Room No: 376, New Delhi, 110029, India. gautamaiims@gmail.com.
authors.forename: Gautam
authors.initials: G
authors.lastname: Sinha
authors.affiliation: Dr Rajendra Prasad Center for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, 110029, India.
authors.forename: Reetika
authors.initials: R
authors.lastname: Sharma
authors.affiliation: Dr Rajendra Prasad Center for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, 110029, India.
authors.forename: Bhagabat
authors.initials: B
authors.lastname: Nayak
authors.affiliation: Dr Rajendra Prasad Center for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, 110029, India.
authors.forename: Bharat
authors.initials: B
authors.lastname: Patil
authors.affiliation: Dr Rajendra Prasad Center for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, 110029, India.
authors.forename: Bibhuti
authors.initials: B
authors.lastname: Kashyap
authors.affiliation: Dr Rajendra Prasad Center for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, 110029, India.
authors.forename: Abdul
authors.initials: A
authors.lastname: Shameer
authors.affiliation: Dr Rajendra Prasad Center for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, 110029, India.
authors.forename: Tanuj
authors.initials: T
authors.lastname: Dada
mesh_terms: D000328:Adult; D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use; D002940:Circadian Rhythm / Q000502:physiology*; D003315:Cornea / Q000000981:diagnostic imaging; D003430:Cross-Sectional Studies; D005260:Female; D005901:Glaucoma / Q000188:drug therapy / Q000503:physiopathology*; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis; D015203:Reproducibility of Results; D014065:Tonometry, Ocular / Q000379:methods* / Q000592:standards; D014463:Ultrasonography
chemical_list: D000959:Antihypertensive Agents
keywords: Central corneal thickness; Diurnal fluctuation; Glaucoma; Goldmann applanation; Intraocular pressure; Tono-Pen
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