Comparison of measurement performance among Tono-Vera vet, Tono-Pen vet, and Tono-Vet plus using an ex vivo porcine eye model

Abstract Background Accurate measurement of intraocular pressure (IOP) is critical in veterinary ophthalmology, yet performance differences between handheld tonometers remain a clinical challenge. This original article aims to directly evaluate the newly launched Reichert® Tono-Vera Vet (TVV) compar...

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Main Authors: Jen-Shuai Chang, Yan-Hui Li, Heng-Ju Lin, Yi-Shan Chiang
Format: Article
Language:English
Published: BMC 2025-06-01
Series:BMC Veterinary Research
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Online Access:https://doi.org/10.1186/s12917-025-04860-3
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author Jen-Shuai Chang
Yan-Hui Li
Heng-Ju Lin
Yi-Shan Chiang
author_facet Jen-Shuai Chang
Yan-Hui Li
Heng-Ju Lin
Yi-Shan Chiang
author_sort Jen-Shuai Chang
collection DOAJ
description Abstract Background Accurate measurement of intraocular pressure (IOP) is critical in veterinary ophthalmology, yet performance differences between handheld tonometers remain a clinical challenge. This original article aims to directly evaluate the newly launched Reichert® Tono-Vera Vet (TVV) compared to two commonly used tonometers, the Icare® Tono-Vet Plus (TVP) and Reichert® Tono-Pen Vet (TPV), using an ex vivo porcine eye model across a wide range of IOP levels. Methods Ten eyes were used to compare the accuracy and consistency of TVV, TVP, and TPV across physiological (5–25 mmHg) and high (30–70 mmHg) intraocular pressure (IOP) ranges. Bias assessment, Bland-Altman plots, regression analysis, and receiver operating characteristic (ROC) analysis were conducted. Results TVV demonstrated superior accuracy in the physiological range, with a mean deviation of 1.16 ± 2.31 mmHg and narrow limits of agreement (min =−3.38 mmHg, max = 5.69 mmHg). At higher pressures, TVV’s variability increased (mean deviation = 0.566 ± 5.95 mmHg). TVP consistently overestimated IOP, particularly at high pressures (mean deviation = 5.68 ± 6.46 mmHg), while TPV significantly underestimated IOP (mean deviation =−11.0 ± 8.55 mmHg; p < 0.001). Bland-Altman analysis confirmed TVV’s better agreement with true IOP in the physiological range. Regression analysis showed a strong correlation for TVV (R² > 0.90), and ROC analysis highlighted its strong discriminative ability (AUC = 0.913). None of the devices effectively differentiated accurate measurements at high IOPs. Conclusions TVV outperformed TVP and TPV in accuracy and consistency, particularly for physiological IOPs. Its reliability supports its use in routine IOP assessments, though all devices showed limitations at elevated pressures.
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spelling doaj-art-57de5130890e48bbbb9231d30d520ad92025-08-20T02:39:24ZengBMCBMC Veterinary Research1746-61482025-06-012111910.1186/s12917-025-04860-3Comparison of measurement performance among Tono-Vera vet, Tono-Pen vet, and Tono-Vet plus using an ex vivo porcine eye modelJen-Shuai Chang0Yan-Hui Li1Heng-Ju Lin2Yi-Shan Chiang3Aurora Animal HospitalAurora Animal HospitalAurora Animal HospitalAurora Animal HospitalAbstract Background Accurate measurement of intraocular pressure (IOP) is critical in veterinary ophthalmology, yet performance differences between handheld tonometers remain a clinical challenge. This original article aims to directly evaluate the newly launched Reichert® Tono-Vera Vet (TVV) compared to two commonly used tonometers, the Icare® Tono-Vet Plus (TVP) and Reichert® Tono-Pen Vet (TPV), using an ex vivo porcine eye model across a wide range of IOP levels. Methods Ten eyes were used to compare the accuracy and consistency of TVV, TVP, and TPV across physiological (5–25 mmHg) and high (30–70 mmHg) intraocular pressure (IOP) ranges. Bias assessment, Bland-Altman plots, regression analysis, and receiver operating characteristic (ROC) analysis were conducted. Results TVV demonstrated superior accuracy in the physiological range, with a mean deviation of 1.16 ± 2.31 mmHg and narrow limits of agreement (min =−3.38 mmHg, max = 5.69 mmHg). At higher pressures, TVV’s variability increased (mean deviation = 0.566 ± 5.95 mmHg). TVP consistently overestimated IOP, particularly at high pressures (mean deviation = 5.68 ± 6.46 mmHg), while TPV significantly underestimated IOP (mean deviation =−11.0 ± 8.55 mmHg; p < 0.001). Bland-Altman analysis confirmed TVV’s better agreement with true IOP in the physiological range. Regression analysis showed a strong correlation for TVV (R² > 0.90), and ROC analysis highlighted its strong discriminative ability (AUC = 0.913). None of the devices effectively differentiated accurate measurements at high IOPs. Conclusions TVV outperformed TVP and TPV in accuracy and consistency, particularly for physiological IOPs. Its reliability supports its use in routine IOP assessments, though all devices showed limitations at elevated pressures.https://doi.org/10.1186/s12917-025-04860-3Tonometer performanceIntraocular pressureBias analysisRegression analysisBland-Altman analysisReceiver operating characteristic analysis
spellingShingle Jen-Shuai Chang
Yan-Hui Li
Heng-Ju Lin
Yi-Shan Chiang
Comparison of measurement performance among Tono-Vera vet, Tono-Pen vet, and Tono-Vet plus using an ex vivo porcine eye model
BMC Veterinary Research
Tonometer performance
Intraocular pressure
Bias analysis
Regression analysis
Bland-Altman analysis
Receiver operating characteristic analysis
title Comparison of measurement performance among Tono-Vera vet, Tono-Pen vet, and Tono-Vet plus using an ex vivo porcine eye model
title_full Comparison of measurement performance among Tono-Vera vet, Tono-Pen vet, and Tono-Vet plus using an ex vivo porcine eye model
title_fullStr Comparison of measurement performance among Tono-Vera vet, Tono-Pen vet, and Tono-Vet plus using an ex vivo porcine eye model
title_full_unstemmed Comparison of measurement performance among Tono-Vera vet, Tono-Pen vet, and Tono-Vet plus using an ex vivo porcine eye model
title_short Comparison of measurement performance among Tono-Vera vet, Tono-Pen vet, and Tono-Vet plus using an ex vivo porcine eye model
title_sort comparison of measurement performance among tono vera vet tono pen vet and tono vet plus using an ex vivo porcine eye model
topic Tonometer performance
Intraocular pressure
Bias analysis
Regression analysis
Bland-Altman analysis
Receiver operating characteristic analysis
url https://doi.org/10.1186/s12917-025-04860-3
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