Intraocular pressure measurements in diabetes mellitus

Eur J Ophthalmol. 2020 Nov;30(6):1432-1439. doi: 10.1177/1120672119890517. Epub 2019 Nov 28.

Abstract

Purpose: To investigate the impact of diabetes mellitus-induced changes on intraocular pressure measurements using Goldmann applanation tonometry, Ocular Response Analyzer, and Corvis ST.

Methods: Measurements were done using Goldmann applanation tonometry, Ocular Response Analyzer, and Corvis ST in 69 diabetic patients. Biomechanical-corrected intraocular pressure values by Ocular Response Analyzer (IOPcc) and Corvis ST (bIOP) were used. In addition, biometry and tomography were performed and information on diabetes mellitus specific factors was collected. Results were compared to an age-matched group of 68 healthy subjects.

Results: In diabetes mellitus, Goldmann applanation tonometry intraocular pressure (P = 0.193) and central corneal thickness (P = 0.184) were slightly increased. Also, IOPcc (P = 0.075) and bIOP (P = 0.542) showed no significant group difference. In both groups, IOPcc was higher than Goldmann applanation tonometry intraocular pressure (P = 0.002, P < 0.001), while bIOP was nearly equal to Goldmann applanation tonometry intraocular pressure (P = 0.795, P = 0.323). Central corneal thickness showed a tendency to higher values in poorly controlled than in controlled diabetes mellitus (P = 0.059). Goldmann applanation tonometry intraocular pressure correlated to central corneal thickness, while IOPcc and bIOP were independent from central corneal thickness in both groups. All intraocular pressure values showed significant associations to corneal biomechanical parameters. Only in diabetes mellitus, bIOP was correlated to Pachy slope (P = 0.023).

Conclusion: In diabetes mellitus, Goldmann applanation tonometry intraocular pressure was slightly, but not significantly, increased, which might be caused by a higher central corneal thickness and changes in corneal biomechanical properties. However, intraocular pressure values measured by Ocular Response Analyzer and Corvis ST were not significantly different between diabetes mellitus patients and healthy subjects. The bIOP showed a higher agreement with Goldmann applanation tonometry than IOPcc and was independent from central corneal thickness.

Keywords: Dynamic Scheimpflug Analyzer Corvis ST; Goldmann applanation tonometry; Intraocular pressure; Ocular Response Analyzer; corneal biomechanics; diabetes mellitus.

MeSH terms

  • Aged
  • Biomechanical Phenomena
  • Biometry
  • Cornea / physiopathology*
  • Cross-Sectional Studies
  • Diabetes Mellitus / physiopathology*
  • Female
  • Humans
  • Intraocular Pressure / physiology*
  • Male
  • Prospective Studies
  • Tonometry, Ocular / methods*