Comparative Study of Central Corneal Thickness Measurement with Slit-Lamp Optical Coherence Tomography and Visante Optical Coherence Tomography

Purpose: To evaluate the repeatability and reproducibility of central corneal thickness (CCT) measurements obtained by 2 anterior segment optical coherence tomography (OCT) imaging systems and to examine their agreements with ultrasound pachymetry. Design: Observational cross-sectional study. Participants: Fifty eyes from 50 healthy normal subjects were recruited. Methods: In one randomly selected eye in each subject, CCT was measured by slit-lamp OCT (SLOCT), Visante OCT, and ultrasound pachymetry. For anterior segment OCT measurements, both automatic and manual CCTs were obtained. Twenty-five of the 50 subjects were invited for 2 more visits within a week to evaluate repeatability and reproducibility of CCT measurement. Main Outcome Measures: Central corneal thickness measurement obtained by the 3 methods and their agreements. Intrasession and intersession within-subject standard deviation (Sw), precision (1.96×Sw), coefficient of variation (CVw) (100×Sw/overall mean), and intraclass correlation coefficient (ICC) were calculated to evaluate repeatability and reproducibility. Results: Good repeatability and reproducibility were found for both automatic and manual CCT measurements obtained by SLOCT and Visante OCT. For intrasession repeatability, CVw and ICC values ranged between 0.9% and 1.2% and 0.96 and 0.98, respectively. For intersession reproducibility, the respective CVw and ICC values ranged between 1.2% and 1.4% and 0.94 and 0.96. Although no significant difference was found between automatic/manual SLOCT measurements and ultrasound pachymetry, automatic Visante OCT CCT (535.7±30.2 μm) was significantly less than CCT with ultrasound pachymetry (550.3±31.14 μm) (P<0.001). In contrast, manual Visante OCT measurement (558.8±32.8 μm) was slightly higher than ultrasound pachymetry (P<0.001). Nevertheless, SLOCT and Visante OCT measurement of CCT had 95% limits of agreement comparable to that of ultrasound pachymetry. The best agreement was observed in the manual SLOCT measurement (95% limits of agreement between -15.5 and 11.7 μm). Conclusions: Both SLOCT and Visante OCT automatic and manual CCT measurements were reliable and showed comparable agreement with ultrasound pachymetry. Although the 2 anterior segment OCT imaging systems have similar design and working principles, clinicians should be aware of the differences in CCT measurement between the 2 anterior segment OCTs.