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BACKGROUND: This study investigated the agreement between a new rebound tonometer, IC200, and IcarePRO and Goldmann applanation tonometry (GAT). METHODS: This was a prospective cross-sectional study. We measured the intraocular pressure (IOP) in 145 eyes of 145 glaucoma patients in the sitting position using GAT, IcarePRO, and IC200. IcarePRO and IC200 measurements were also obtained in the supine position. IC200 measurement was performed using two modes: single six (IC200-single) and automatic (IC200-continuous) six-measurements mode. RESULTS: All tonometers provided high reproducibility in both positions (all intraclass correlation coefficients > 0.90), although it was highest with GAT, followed by IC200-continuous and IC200-single and then IcarePRO. In the sitting position, the mean (± SD) IOPs of GAT, IcarePRO, IC200-single, and IC200-continuous were 14.5 ± 2.9 mmHg, 13.3 ± 3.2 mmHg, 11.6 ± 3.2 mmHg, and 11.5 ± 3.2 mmHg, respectively. IOPs measured with IcarePRO or IC200 were significantly lower than those with GAT, particularly in patients with low IOP. IOPs measured with all tonometers were significantly elevated in the supine position as compared with the sitting position, but this difference was significantly greater with IC200-single and IC200-continuous compared with IcarePRO. IOP elevation was significant in eyes without bleb versus those with bleb, but this finding was not observed when IOP was measured with IcarePRO. The IOPs of the single and continuous modes of IC200 were interchangeable in both positions. CONCLUSIONS: GAT, IcarePRO, and IC200 had sufficiently high reproducibility, but measurements with IcarePRO may not be accurate in the supine position. Elevation of IOP in the supine position, especially in eyes with bleb, was more sensitively captured with IC200 than with IcarePRO. TRIAL REGISTRATION: Japan Clinical Trials Register, No. UMIN000039982 .
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OBJECTIVES: We evaluated early medication persistence with new topical antiglaucoma eyedrops, omidenepag isopropyl 0.002% (a selective prostaglandin EP2 agonist). DESIGN AND SETTING: Retrospective two-institute study in Himeji and Akashi in Japan. PARTICIPANTS: We analysed patients with glaucoma who were prescribed topical omidenepag isopropyl from November 2018 to December 2019. From the last outpatient visit of patients until February 2020, 235 patients were prescribed a new solution of omidenepag isopropyl (129 patients in the initial monotherapy group, 85 in the switching group (switched from another topical antiglaucoma eyedrops), 19 added to another topical antiglaucoma eyedrops group, and 2 were lost to follow-up)). Additionally, we recruited 98 patients (3 were lost to follow-up) who received initial latanoprost 0.005% monotherapy during the same period as a control group. OUTCOMES: Medication persistence failure was defined as drug discontinuation due to any adverse effects or change of therapy. Kaplan-Meier survival analysis was performed with a Cox regression analysis. RESULTS: Among 233 patients, 48 (20%) showed failure of treatment; the median persistence time of all patients was 165 days, and the median time until discontinuation of omidenepag isopropyl was 45 days. The total persistence rates were 85%, 80% and 70% at 3, 6 and 12 months, respectively. Risk factors for failure were male gender (HR: 1.45, p=0.023) and monotherapy/switching (HR: 1.715, p=0.002). Comparison between latanoprost and omidenepag isopropyl monotherapy, only male gender (HR: 1.43, p=0.016) was a significant risk factor. Failures associated with omidenepag isopropyl were due to insufficient intraocular pressure-lowering efficiency (n=26, observed during all the period), followed by conjunctival hyperaemia (n=10) and visual acuity disturbance (n=5) in patients who were observed until 3 months. CONCLUSION: Medication persistence with omidenepag isopropyl is mostly positive; however, clinicians should also be cautious of early failure.
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Glaucoma , Prostaglandinas , Antihipertensivos/uso terapéutico , Femenino , Glaucoma/tratamiento farmacológico , Glicina/análogos & derivados , Humanos , Presión Intraocular , Japón , Masculino , Cumplimiento de la Medicación , Soluciones Oftálmicas , Pirazoles , Piridinas , Estudios RetrospectivosRESUMEN
PURPOSE: We investigated the ease of use and accuracy of a new self/home-tonometer (IcareHOME) versus Goldmann applanation tonometry (GAT) and the Icare tonometer (Icare) by measuring the diurnal intraocular pressure (IOP). PATIENTS AND METHODS: The right eyes of 43 healthy young subjects were studied. The IOP was measured using the IcareHOME, GAT, and Icare 6 times a day, every 2 hours, from 8:00 to 18:00. The coincidence of the diurnal curves among all tonometers was analyzed using a linear mixed model. The intradevice and interdevice agreement was evaluated using the intraclass correlation coefficients (ICC) and Bland-Altman method. The subjects' perception of the IcareHOME was evaluated using a questionnaire. RESULTS: The liner mixed model showed similar diurnal IOP curves for all tonometers (P=0.543); however, significant differences were observed between the tonometers over time (P<0.001). The intradevice repeatability was ICC>0.8 among all tonometers, although the interdevice agreement was lowest between the IcareHOME and GAT (ICC=0.641). The IOP values were significantly lower for the IcareHOME than for the GAT at 12:00, 16:00, and 18:00 (P<0.05, Tukey-Kramer test). The mean differences between the Icare and IcareHOME and GAT and IcareHOME were 0.83 and 1.03 mm Hg, respectively (95% limit of agreement: -4.17 to 5.84 mm Hg and -3.91 to 5.98 mm Hg, respectively). Regarding the subjects' perception of handling the IcareHOME, 17 (39.5%) subjects answered "easy to use," 20 (46.5%) answered "normal," and six (13.9%) answered "difficult to use." CONCLUSIONS: The IcareHOME can be used as a self/home-tonometer; however, it may result in lower IOP values.