Ocular Response Analyzer의 재현성 및 골드만압평안압, 비접촉안압과의 비교
Reproducibility of Ocular Response Analyzer and Comparison with Goldmann Applanation Tonometer and Non-Contact Tonometer
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목적: Ocular Response Analyzer (ORA)의 재현성을 평가하고, ORA, 골드만압평안압계(GAT), 비접촉안압계(NCT)로 측정한 안압 간의차이를 알아보았다. 대상과 방법: 정상인 45명 45안을 대상으로 3명의 검사자가 ORA를 시행하였으며 독립된 검사자가 GAT와 NCT를 측정하였다. ORA의재현성은 ANOVA-based Intraclass correlation coefficient (ICC)와 coefficient of variation (CV)을 이용하여 평가하였다. 결과: ORA 계측치의 검사자 간 재현성은 우수하였다. 검사자 내 재현성은 IOP cc, CRF에서 매우 우수하였으나 CH는 검사자에 따라재현성의 차이가 있었다. IOP cc는 IOP g와 의미 있는 차이가 있었으나(p=0.04), GAT와 NCT로 측정한 안압과는 차이가 없었다. IOP cc만 중심각막두께와 상관관계가 없었다(p=0.38). 결론: ORA 계측치의 검사자 간 재현성은 우수하였고, 검사자 내 재현성은 IOP cc, CRF에서 우수하였다. ORA 안압은 GAT와 NCT로측정한 안압과 차이를 보이지 않았다.
Abstract
Purpose: To evaluate the inter- and intra-observer variability of ocular response analyzer (ORA) measurements, and to evaluate the relationships among the intraocular pressures (IOPs) obtained by ORA, Goldmann applanation tonometer (GAT) and non-contact tonometer (NCT). Methods: The present study included 45 normal eyes from 45 volunteers. Three masked observers performed ORA measurements. NCT and GAT measurements were performed by one independent observer. The reproducibility of ORA was assessed by ANOVA-based intraclass correlation coefficient (ICC) and coefficient of variation (CV). Comparison among the tonometers was performed using the Bland-Altman plot and paired t-test. Results: The ICC for inter-observer reproducibility of ORA parameters was 0.90 to 0.97. The corresponding CV values were 13.2% to 19.1%. The intra-observer ICC values for IOP cc were 0.78 to 0.88. CV was 11.2% to 16.8%. For CRF, ICC values were 0.80 to 0.84 with CV values as 11.6% to 15.9%. For CH, ICC values were 0.74 to 0.82 and CV values were 13.0% to 15.9%. The difference in mean IOP values between IOP cc and IOP g was statistically significant (p = 0.04). However, no difference was found among other tonometers, and only IOP cc did not result in significant correlation with central corneal thickness (CCT) (p = 0.38). Conclusions: The intra- and inter-observer reproducibility was substantial for IOP cc, IOP g, CH and CRF, for all observers. Additionally, IOP measured with ORA did not result in significant differences from GAT and NCT.
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