ĐÁNH GIÁ SỰ CHÊNH LỆCH TRỊ SỐ NHÃN ÁP GIỮA CÁC PHƯƠNG PHÁP ĐO NHÃN ÁP TẠI BỆNH VIỆN MẮT NGHỆ AN

Abstract

Background: Intraocular pressure (IOP) is a critical parameter in the diagnosis and monitoring of ocular diseases, particularly glaucoma. Common tonometry methods, including the Maclakov tonometer, Goldmann applanation tonometry, and non-contact tonometry, may yield different results, potentially affecting clinical assessment.

Methods: A cross-sectional descriptive study was conducted on 689 eyes of patients aged ≥15 years at Nghe An Eye Hospital from March to August 2025. IOP was measured using three methods: Maclakov, Goldmann applanation, and non-contact tonometry. Mean IOP values and inter-method differences were compared across IOP levels.

Results: Mean intraocular pressure (IOP) differed significantly among disease groups, with the highest values in glaucoma and the lowest in retinal detachment (p<0.001). At IOP levels <22 mmHg, Maclakov yielded higher values, whereas at ≥26 mmHg, Goldmann and non-contact tonometry showed higher readings. Non-contact tonometry tended to give higher values than Goldmann in eyes with IOP >21 mmHg. Most measurements obtained by Goldmann (77.7%) and non-contact tonometry (63.1%) were lower than those from Maclakov. Differences reached up to 16 mmHg but were mostly within ±3 mmHg. The methods showed strong correlations (r ≈ 0.91–0.95; p<0.001); however, Bland–Altman analysis indicated wide limits of agreement (approximately ±8 mmHg).

Conclusion: Significant differences exist among IOP measurement methods, varying according to IOP levels and showing a reversal trend between low and high ranges. These discrepancies should be considered when comparing and monitoring IOP in clinical practice.