Impact of self‐tonometry on glaucoma treatment decision
Laurence Quérat, Enping Chen
Abstract
Abstract Purpose The aim of this study was to examine the impact of self‐tonometry on clinicians' decision in glaucoma treatment. Materials and Methods Medical records of 133 patients who had performed self‐tonometry using iCare ® Home between January and December 2019 were retrospectively reviewed. Inclusion criteria were as follows: age over 18 years, all types of glaucoma, as well as ocular hypertension and glaucoma suspect, compliance with tonometer manufacturer's recommendations and monitoring over at least 2 days. The data consisted of age, gender, diagnosis, visual field index, rate of progression and type of treatment pre‐ and post‐intraocular pressure (IOP) phasing. The following IOP measurements were used to calculate the mean and maximum IOP, and range over each day and consecutive days: Goldmann applanation tonometry (GAT) measurements from referral and training visits and iCare ® Home measurements made by the trainers and the patients themselves. A total of 90 patients were included. Results Clinicians were satisfied with the actual treatment in 54.4% of the cases. There was a statistically significant difference between the clinicians' decision to maintain same treatment or to escalate therapy for all the mean and maximum IOPs measured on each single day and over a 2‐ or 3‐day period ( p < 0.002). Conclusion Our results suggest that the presence of high IOP values obtained with self‐tonometry supports an intensification of glaucoma treatment. Self‐tonometry provides clinicians with an important complement for clinical decision‐making, and under‐ or over‐treatment may be avoided for the benefit of patients.