Vidal Silvia, Viqueira Valentín, Mas David, Domenech Begoña
Department de Optica, Universidad de Alicante, San Vicente del Raspeig, Alicante, Spain.
Clin Exp Optom. 2013 May;96(3):278-85. doi: 10.1111/cxo.12002. Epub 2013 Jan 14.
The aim of this study is to determine the reliability of corneal thickness measurements derived from SOCT Copernicus HR (Fourier domain OCT).
Thirty healthy eyes of 30 subjects were evaluated. One eye of each patient was chosen randomly. Images were obtained of the central (up to 2.0 mm from the corneal apex) and paracentral (2.0 to 4.0 mm) cornea. We assessed corneal thickness (central and paracentral) and epithelium thickness. The intra-observer repeatability data were analysed using the intra-class correlation coefficient (ICC) for a range of 95 per cent within-subject standard deviation (S(W)) and the within-subject coefficient of variation (C(W)). The level of agreement by Bland-Altman analysis was also represented for the study of the reproducibility between observers and agreement between methods of measurement (automatic versus manual).
The mean value of the central corneal thickness (CCT) was 542.4 ± 30.1 μm (SD). There was a high intra-observer agreement, finding the best result in the central sector with an intra-class correlation coefficient of 0.99, 95 per cent CI (0.989 to 0.997) and the worst, in the minimum corneal thickness, with an intra-class correlation coefficient of 0.672, 95 per cent CI (0.417 to 0.829). Reproducibility between observers was very high. The best result was found in the central sector thickness obtained both manually and automatically with an intra-class correlation coefficient of 0.990 in both cases and the worst result in the maximum corneal thickness with an intra-class correlation coefficient of 0.827. The agreement between measurement methods was also very high with intra-class correlation coefficient greater than 0.91. On the other hand the repeatability and reproducibility for epithelial measurements was poor.
Pachymetric mapping with SOCT Copernicus HR was found to be highly repeatable and reproducible. We found that the device lacks an appropriate ergonomic design as proper focusing of the laser beam onto the cornea for anterior segment scanning required that patients were positioned slightly farther away from the machine head-rest than in the setup for retinal imaging.
本研究旨在确定源自SOCT哥白尼HR(傅里叶域光学相干断层扫描)的角膜厚度测量的可靠性。
对30名受试者的30只健康眼睛进行评估。随机选择每位患者的一只眼睛。获取中央(距角膜顶点2.0毫米以内)和旁中央(2.0至4.0毫米)角膜的图像。我们评估角膜厚度(中央和旁中央)以及上皮厚度。使用组内相关系数(ICC)分析观察者内重复性数据,范围为受试者内标准差(S(W))的95%以及受试者内变异系数(C(W))。还通过布兰德-奥特曼分析表示一致性水平,用于研究观察者之间的可重复性以及测量方法(自动与手动)之间的一致性。
中央角膜厚度(CCT)的平均值为542.4±30.1微米(标准差)。观察者内一致性较高,在中央区域结果最佳,组内相关系数为0.99,95%置信区间(0.989至0.997),而在最小角膜厚度处最差,组内相关系数为0.672,95%置信区间(0.417至0.829)。观察者之间的可重复性非常高。在中央区域厚度方面,手动和自动测量均获得最佳结果,组内相关系数均为0.990,而在最大角膜厚度处结果最差,组内相关系数为0.827。测量方法之间的一致性也非常高,组内相关系数大于0.91。另一方面,上皮测量的重复性和可重复性较差。
发现使用SOCT哥白尼HR进行测厚绘图具有高度的可重复性和可再现性。我们发现该设备缺乏合适的人体工程学设计,因为将激光束正确聚焦到角膜上以进行眼前节扫描要求患者比视网膜成像设置时离机器头枕稍远一些。