Validation of the Reichert® Tono-Vera® Vet rebound tonometer in normal ex vivo canine eyes.

OBJECTIVE: To determine the accuracy of the Reichert® Tono-Vera® Vet rebound tonometer for canine intraocular pressure (IOP) measurement. ANIMALS STUDIED: Five normal canine ex vivo globes. PROCEDURES: The anterior chambers of five freshly enucleated normal canine eyes were cannulated and connected to a reservoir of Plasma-Lyte A and a manometer. Starting at a manometric IOP of 5 mmHg, the pressure was progressively increased to 80 mmHg by raising the reservoir. Triplicate IOP measurements were taken with the Tono-Vera® Vet from the central cornea using the dog setting and compared to the manometric pressure by linear regression analysis and Bland-Altman plots. RESULTS: There was a strong positive linear regression trend when comparing central corneal Tono-Vera® Vet IOPs to manometric pressures (r2 = .99) with solid agreement between the two methods. Compared to manometric IOPs, the Tono-Vera® Vet underestimated IOPs at higher pressures ≥70 mmHg. CONCLUSIONS: Measurement of IOPs from the central cornea with the Tono-Vera® Vet provided accurate results over a large range in normal canine globes compared to direct manometry. The mild to moderate underestimation of IOPs at high pressures was not considered clinically relevant.

Efficacy of the positioning system when measuring canine intraocular pressures with the Reichert® Tono-Vera® Vet rebound tonometer.

OBJECTIVE: To compare intraocular pressure (IOP) measurements in dogs taken with the Reichert® Tono-Vera® Vet rebound tonometer with and without the automatic positioning system. ANIMALS STUDIED: Measurements were taken on 49 eyes from 26 Beagle-derived dogs with variable genetics-four non-glaucomatous and 22 ADAMTS10-mutant dogs affected with different stages of open-angle glaucoma. Seventeen of the 26 dogs were measured 2-4 times on different days with variable intervals since IOP-lowering medications were administered. PROCEDURES: In each dog, tonometry was performed with the Tono-Vera® Vet using three different methods in a randomized order: (Method 1) Average of three readings with an automatic positioning system; (Method 2) one reading with an automatic positioning system; and (Method 3) average of three readings obtained without the automatic positioning system. Statistical analyses included one-way ANOVA, Tukey pairwise comparisons, and Bland-Altman plots (MiniTab®). RESULTS: With each of the three tonometry methods, 116 measurements were taken, resulting in 348 total IOP measurements with a range of 12.8-49.9 mmHg. The means and standard deviations for each method were 25.4 ± 6.9 mmHg (Method 1), 26.0 ± 7.2 mmHg (Method 2), and 26.9 ± 7.7 mmHg (Method 3), with no significant differences (p = .27). Mean IOP variances were also not significantly different between tonometry methods (p = .24 to .78). CONCLUSIONS: Because mean IOPs and their standard deviations were not statistically different between the three tonometry methods, we conclude that Tono-Vera® Vet measurements conducted without the aid of the positioning system still provide reliable results.

Validation of the eyeTelemed IOPvet indentation tonometer for use in dogs.

OBJECTIVE: To assess the accuracy of canine intraocular pressure (IOP) estimates from the eyeTelemed IOPvet indentation tonometer. ANIMALS STUDIED: Part 1 included 54 eyes from 28 Beagle dogs-23 ADAMTS10-mutants with open-angle glaucoma and 5 normals. Part 2 involved five normal canine ex vivo globes. PROCEDURE: Part 1 (in vivo) compared IOPvet estimates in normal and glaucomatous dogs to Reichert Tono-Vera® Vet rebound tonometry. The three IOPvet estimates were green (normal; <20 mmHg, according to the manufacturer), yellow (elevated; 20-30 mmHg), and red (high; >30 mmHg). In Part 2 (ex vivo), the pressure inside freshly enucleated normal canine eyes was progressively increased from 5 to 80 mmHg and compared to IOPvet estimates. Descriptive statistics compared IOPvet estimates to rebound tonometry and direct manometry, with the threshold from normal to glaucoma set at 30 mmHg. RESULTS: In Part 1 (in vivo), normal pressures (≤30 mmHg) were mainly identified correctly as green or yellow-110 of 111 estimates, corresponding to a specificity of 99%. Only 16 of 125 affected estimates were correctly displayed in the >30-mmHg range; the remaining 109 showed ≤30 mmHg, corresponding to a sensitivity of 13%. In Part 2 (ex vivo), all normal pressures were correctly estimated with green, but 64 of 88 manometric IOPs >30 mmHg were falsely estimated as 20-30 mmHg. CONCLUSIONS: The IOPvet is inaccurate in estimating canine IOP with a low sensitivity at identifying dogs with IOP > 30 mmHg. Canine-specific instrument revision is required to correctly identify elevated (yellow = 20-30 mmHg) and high (red >30 mmHg) IOPs.

Intra-articular triamcinolone acetonide injection results in increases in systemic insulin and glucose concentrations in horses without insulin dysregulation.

BACKGROUND: Corticosteroids are a commonly used, inexpensive intra-articular treatment for osteoarthritis which may increase the risk for laminitis in horses due, in part, to hyperinsulinaemia. Humans with metabolic syndrome experience increases in insulin and glucose concentrations post-injection, but responses in horses are unknown. OBJECTIVES: To determine the effect of a single intra-articular (IA) dose of triamcinolone acetate (TA) on blood insulin and glucose concentrations. STUDY DESIGN: Before-after study. METHODS: Ten horses with normal insulin regulation as assessed by an oral sugar test received 18 mg of TA into one middle carpal joint. Insulin and glucose concentrations were evaluated at baseline and 4, 6, 8, 24, 48, and 72 h following IA corticosteroid injection. Differences from baseline were evaluated using a repeated measures ANOVA with Dunnett's multiple comparison testing or a Friedman test with Dunn's correction (significant at p < 0.05). RESULTS: Mean ± SD blood insulin concentration post IA TA injection was increased at 6 h (15.8 ± 3.1 µIU/mL, p = 0.01), 24 h (23 ± 5.8 µIU/mL, p ≤ 0.001), and 48 h (29 ± 13 µIU/mL, p ≤ 0.01) compared to baseline (10 ± 12.3 µIU/mL), with the peak at 48 h. Median ± 95% CI blood glucose concentration post IA TA injection was increased at 6 h (112.7 ± 20.3 mg/dL, p = 0.006), 8 h (112.9 ± 21.4 mg/dL, p = 0.004), 24 h (122.6 ± 14.6, p ≤ 0.0001), and 48 h (123.5 ± 15.4 mg/dL, p ≤ 0.0001) compared to baseline (89.2 ± 6.6 mg/dL), with the peak at 48 h. MAIN LIMITATIONS: Only horses with normal insulin regulation were evaluated. CONCLUSIONS: Blood insulin and glucose concentrations modestly increased for 48 h following IA TA.