アイケアHOME2による眼圧自己測定値と他者測定値の比較

Comparison of self-measured and clinician-measured IOP using iCare HOME2

要約　目的：アイケアHOME2手持眼圧計TA023（以下，アイケアHOME2）（Icare Finland社）は，患者自身が眼圧を自己測定できるホームトノメトリーデバイスである。今回，筆者らはアイケアHOME2による自己測定と診療従事者による他者測定を同時に施行し，結果を比較検討した。

対象と方法：対象は三重大学医学部附属病院眼科に通院中の緑内障患者41例41眼（平均年齢65.6±8.9歳，男性20例／女性21例）。まず診療従事者がアイケアHOME2を用いて眼圧測定を行い，直後に同じアイケアHOME2により患者本人が眼圧測定を行った。それぞれの眼圧測定値を他者測定値および自己測定値とし，比較検討した。

結果：他者測定による平均眼圧値は13.9±6.5mmHg，自己測定による平均眼圧値は14.7±6.7mmHgであり，自己測定値のほうが有意に眼圧が高かった（p＜0.01，対応のあるt検定）。他者測定値と自己測定値の相関係数は0.972（p＜0.01）と高かった。Bland-Altman解析の結果，固定誤差の平均は＋0.83mmHg，固定誤差の標準偏差は1.56mmHg，上限限界は＋3.89mmHg，下限限界は−2.24mmHgであった。比例誤差は認めなかった（p＝0.487）。

結論：アイケアHOME2による自己測定値は，診療従事者による測定値と比べて平均0.83mmHg高かった。他者測定値と自己測定値の間には固定誤差を認めたが，比例誤差はなく，両者は高い相関関係にあった。

Abstract　Purpose：The iCare HOME2 handheld tonometer TA023（iCare HOME2）facilitates self-measurement of intraocular pressure（IOP）at various time-points during the day. This study aimed to compare simultaneous self-measurements acquired using the iCare HOME2 with those acquired by healthcare professionals.

Subjects and Methods：Forty-one eyes of 41 patients with glaucoma（mean age 65.6±8.9 years；20 men and 21 women）who presented to the Department of Ophthalmology at Mie University Hospital were included in this study. Healthcare professionals measured IOP using iCare HOME2 initially；the patients measured the IOP using the same device immediately afterward. These IOP measurements were compared with those acquired by healthcare professionals（other-measurements）.

Results：The mean IOP measured by healthcare professionals and those measured by the patients were 13.9±6.5 mmHg and 14.7±6.7 mmHg, respectively（p＜0.01, paired t-test）, indicating significant differences. The correlation coefficient（0.972）between the two measurement methods was extremely high（p＜0.01）. Bland-Altman analysis revealed a mean fixed bias of ＋0.83 mmHg. The standard deviation was ±1.56 mmHg, with upper and lower limits of agreement of ＋3.89 mmHg and −2.24 mmHg, respectively. No proportional bias was detected（p＝0.487）.

Conclusion：Self-measurements acquired using the iCare HOME2 were, on average, 0.83 mmHg higher than those acquired by healthcare professionals. A fixed bias existed between the two methods；however, no statistically significant proportional bias was observed. A high correlation was observed between them.