Comparative Assessment of Intraocular Pressure Measurement Methods in Patients with Graves’ Ophthalmopathy And Ocular Hypertension

Background. Graves' ophthalmopathy (GO) is associated with structural and functional orbital changes that may influence intraocular pressure (IOP) and complicate its accurate measurement. Reliable IOP assessment is essential for timely diagnosis of ocular hypertension and prevention of glaucomatous damage; however, the performance of different tonometry methods in GO patients remains insufficiently studied. Objective. To perform a comparative analysis of IOP measurements obtained using different tonometry methods in patients with GO and ocular hypertension, and to evaluate the variability between these methods. Methods. A cohort comparative study was conducted between 2021 and 2024 at the Republican Specialized Scientific and Practical Center of Endocrinology. The study included patients with GO and ocular hypertension (n = 38). IOP was measured using Goldmann applanation tonometry, non-contact tonometry, and the Maklakov tonometer. Statistical analysis included calculation of mean values, standard deviation, and comparison using Student’s t-test, with p < 0.05 considered statistically significant. Results. The highest IOP values were obtained using the Maklakov method (29.5±3.5 mmHg), compared to Goldmann applanation tonometry (23.2±2.1 mmHg) and non-contact tonometry (22.9±2.3 mmHg). Significant differences were found between Maklakov and Goldmann methods (p<0.01), as well as between Maklakov and non-contact tonometry (p<0.01). No significant difference was observed between Goldmann and non-contact methods (p=0.342). The mean differences in IOP were 5.64 mmHg between Maklakov and Goldmann methods and 6.12 mmHg between Maklakov and non-contact tonometry. Corneal thickness analysis showed that 86.8% of eyes had normal values, while deviations potentially affecting IOP measurement were observed in a minority of cases. Conclusion. Goldmann applanation tonometry remains the most reliable method for IOP assessment in patients with GO. The Maklakov method tends to overestimate IOP, particularly at higher pressure levels, which may lead to overdiagnosis of ocular hypertension or glaucoma. Accurate evaluation of IOP in this patient population requires consideration of corneal properties and the use of precise measurement techniques.

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