Wirklich gute Übereinstimmung zwischen Rebound- und Goldmann-Applanationstonometrie? Ergebnisse eines Systematic Review zum Zeitraum 01/2005 bis 08/2014

 

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Zusammenfassung

Fragestellung: Nach Einführung im Jahr 2003 fand die iCare®-Rebound-Tonometrie schnelle Verbreitung nicht zuletzt aufgrund zeitnah publizierter Studien, welche eine hohe Übereinstimmung mit der Goldmann-Applanationstonometrie (GAT) als diagnostischer Referenz attestierten. Ziel dieses Systematic Review war es, die bisher verfügbare Literatur zur Konkordanz von iCare®-Rebound- und Goldmann-Applanationstonometrie zusammenzuführen. Methodik: Mittels PubMed wurde zum Zeitraum Januar 2005 bis August 2014 eine Recherche zu Publikationen des angloamerikanischen und deutschen Sprachraums zu intraindividuellen Vergleichen der Tonometriemethoden vorgenommen. Primärer Endpunkt des Reviews war die berichtete intraindividuelle IOD-Abweichung [mmHg] zwischen den Geräten; Angaben zum primären Endpunkt wurden aggregiert als „mittlere intraindividuelle Abweichung“ sowie dem „Anteil [%] der Messungen mit Abweichung ≥ ± 3 mmHg“. Eingeschlossen werden konnten 33 das Modell iCare® TA01i betreffende publizierte Konkordanzbewertungen, davon 17 im Erscheinungszeitraum 01/2009 bis 08/2014. Analysierte Fallzahlen rangierten dabei zwischen 28 und 445 Augen; 17 der 33 Studien berichteten Ergebnisse zu mehr als 100 Augen. Sieben der 33 Studien schlossen nur augengesunde Probanden ein. Ergebnisse: Es wurden in allen Studien Kennwerte zur intraindividuellen Abweichung der IOD-Messergebnisse gemacht, 10 der 33 Studien berichteten eine mittlere Abweichung um mehr als ± 1,5 mmHg (7 dieser Studien wurden im Zeitraum 01/2009 bis 08/2014 publiziert). Nur 12 der 33 Studien berichteten Angaben zur Häufigkeit intraindividueller Abweichungen zwischen iCare® TA01i und GAT um ≥ ± 3 mmHg: Der berichtete Anteil betrug in 7 Studien > 20 % (maximal 51 %), wobei die höheren Anteile aus Studien an Patienten mit tendenziell hohem Ausgangs-IOD laut GAT-Referenzmessung erwuchsen. Schlussfolgerung: Derzeit kann aus der Literatur keine Austauschbarkeit von iCare®-Rebound- und Goldmann-Applanationstonometrie abgeleitet werden.

Abstract

Background: After its introduction in 2003 the iCare® rebound tonometry has gained wide acceptance, mostly as a result of immediate method comparison trials showing high concordance with the Goldmann applanation tonometry (GAT) as a reference method. The objective of this systemic review was the synopsis of the current literature as a rationale of a concordance evaluation between the iCare® rebound and the Goldmann applanation tonometry methods. Methods: The PubMed database was searched for Anglo-American and German publications comparing intraindividually the two tonometry methods and having been published during the period 01/2005 to 08/2014. The primary endpoint of the review was the reported IOD deviation [mmHg] between the two devices; for each trial, this primary endpoint was parameterised in terms of the “mean deviation” as well as the “relative frequency [%] of measurements with an intraindividual deviation of ≥ ± 3 mmHg”. A total of 33 published method comparison studies concerning the iCare TA01i device were included, 17 of them being published between 01/2009 and 08/2014. The number of analysed eyes ranged between 28 and 445; 17 of the 33 studies reported more than 100 examined eyes. 7 of the 33 studies included only healthy eyes. Results: Only 10 out of the 33 studies reported a mean deviation of more than ± 1.5 mmHg, 7 of these were published between 01/2009 and 08/2014. Only 12 of the 33 studies reported the relative frequency of intraindividual deviations ≥ ± 3 mmHg, 7 of them reporting a frequency > 20 % (with a maximum of 51 %), with higher frequencies being derived from samples showing higher IOD levels according to the GAT reference. Conclusion: As concluded from the current literature the iCare® rebound and the Goldmann applanation tonometry methods cannot be considered exchangable.

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