Repeatability and Reproducibility of Slit Lamp, Optical Coherence Tomography, and Scheimpflug Measurements of Corneal Scars.

Abstract

Purpose: To determine the repeatability and reproducibility of anterior segment optical coherence tomography (AS-OCT) and Scheimpflug photography for several measurements of corneal scars, including scar size, scar depth, and corneal thickness. Methods: A series of patients treated for fungal keratitis at a tertiary eye care center in South India were recalled two years after successful treatment. Eyes with corneal scars had a slit lamp examination performed by two ophthalmologists masked to the other's examination. For AS-OCT and Scheimpflug photography, each eye had two scans taken by one technician and a third scan taken by a separate technician. Scar measurements were subsequently assessed from AS-OCT images by three graders masked to each other's results. Repeatability and reproducibility were assessed by calculating the intra-class correlation coefficient (ICC) from mixed effects linear regression models. Results: Fifty eyes had all measurements taken. The corneal scar size, measured as the geometric mean of the two longest perpendicular meridians, ranged from 0.8 to 5.4 (mean 2.8 mm, 95%CI 2.6 to 3.1). Scar size measurements taken by two separate individuals were most reproducible when the border of the scar was traced from the OCT (ICC 0.90, 95%CI 0.86 to 0.94), and least repeatable when assessed from slit lamp examination (ICC 0.80, 95%CI 0.70 to 0.90). Conclusions: AS-OCT and Scheimpflug imaging of corneal scars produced measurements with acceptable reproducibility that could be useful as cornea-specific outcomes for clinical trials.

• Authors: Manoranjan Das, Shivali A Menda, Arun K Panigrahi, N Venkatesh Prajna, Michael Yen, Betty Tsang, Alisha Kumar, Jennifer Rose-Nussbaumer, Nisha R Acharya, Charles E McCulloch, Thomas M Lietman, Stephen D McLeod, Jeremy D Keenan
• Journal: Ophthalmic epidemiology (Ophthalmic Epidemiol) Vol. 26 Issue 4 Pg. 251-256 (08 2019) ISSN: 1744-5086 [Electronic] England
• PMID: 31018742 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Antifungal Agents

Topics

• Adult
• Antifungal Agents (therapeutic use)
• Cicatrix (diagnosis, etiology)
• Cornea (pathology)
• Corneal Pachymetry (methods)
• Corneal Ulcer (complications, diagnosis, drug therapy)
• Eye Infections, Fungal (complications, diagnosis)
• Female
• Humans
• Male
• Middle Aged
• Reproducibility of Results
• Slit Lamp Microscopy (methods)
• Tomography, Optical Coherence (methods)