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Repeatability, Reproducibility, and Age Dependency of Dynamic Scheimpflug-Based Pneumotonometer and Its Correlation With a Dynamic Bidirectional Pneumotonometry Device

Bak-Nielsen, Sashia MD; Pedersen, Iben Bach MD; Ivarsen, Anders MD, PhD; Hjortdal, Jesper MD, PhD, DMSci

doi: 10.1097/ICO.0000000000000293
Clinical Science

Purpose: To assess the repeatability, reproducibility, and age dependency of dynamic Scheimpflug-based pneumotonometry (Corvis)–generated parameters and their correlation with dynamic bidirectional pneumotonometry device [Ocular Response Analyzer (ORA)] measurements [corneal hysteresis (CH) and corneal resistance factor (CRF)].

Methods: Eyes of 29 healthy participants between 20 and 30 years old were measured using Corvis and ORA. Measurements were performed twice in a row and repeated after 1 week. Repeatability and reproducibility were examined by calculating intraday and interday coefficients of variation (CVs). Corvis measurements were compared with measurements from 19 participants older than 65 years.

Results: The most repeatable and reproducible Corvis-generated parameters, with intraday and interday CVs < 10% were as follows: intraocular pressure (IOP), pachymetry, time to first and second applanation (A1 time, A2 time), radius and amplitude at highest concavity (HC radius and HC deformation amplitude, respectively), time to highest concavity (HC time), deflection length and amplitude at highest concavity [HC deflection length and HC deflection amplitude (millimeter), respectively], and time to highest deflection amplitude [HC deflection amplitude (millisecond)]. However, 7 of 19 analyzed parameters showed CVs > 10%. HC-related parameters showed significant age dependency. The correlation between Corvis and ORA was weak (A2 time and CH, r = 0.36, A1 time and CRF, r = 0.41). Corvis-derived IOP was on average 2.2 ± 2.3 mm Hg higher than cornea-compensated IOP, with large differences in patients with high-average IOP.

Conclusions: The considerable variation in repeatability and reproducibility should be taken into account when using the Corvis. Corvis parameters showed poor correlation with CH and CRF obtained by ORA measurements.

Department of Ophthalmology, Aarhus University Hospital, Aarhus, Denmark.

Reprints: Iben Bach Pedersen, MD, Department of Ophthalmology, Aarhus University Hospital, Noerrebrogade 44, 8000 Aarhus C, Denmark (e-mail:

Supported by Fight for Sight, Denmark, the Department of Clinical Medicine, Aarhus University, and Bagenkop-Nielsens Myopia Foundation.

The authors have no conflicts of interest to disclose.

S. Bak-Nielsen and I. B. Pedersen have contributed equally to this study and should be considered equivalent first authors.

The study was reviewed by the Central Denmark Region Committees on Health Research Ethics and classified as a quality control study (Study number: 1-10-72-488-12).

Received May 20, 2014

Received in revised form September 10, 2014

Accepted September 21, 2014

Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.