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      Comparison of central corneal thickness measurements in corneal edema using ultrasound pachymetry, Visante anterior-segment optical coherence tomography, Cirrus optical coherence tomography, and Pentacam Scheimpflug camera tomography

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          Abstract

          Purpose

          To compare the central corneal thickness (CCT) measurements in subjects with corneal edema using ultrasound pachymetry, Visante anterior-segment optical coherence tomography (OCT), Cirrus OCT, and Pentacam Scheimpflug camera tomography.

          Methods

          This prospective cross-sectional study included 46 eyes of 33 patients with corneal edema and a CCT exceeding 550 μm evaluated by ultrasound pachymetry, Visante OCT, Cirrus OCT, and Pentacam. Two observers measured each eye twice. Intraobserver and interobserver reproducibility were determined and agreement among the devices calculated.

          Results

          CCT was measured in 40 eyes of 29 patients. Regardless of the CCT, the measurements obtained using Visante OCT, Cirrus CCT, and ultrasound pachymetry were well correlated. Interobserver and intraobserver reproducibility were high among the three devices. Pentacam overestimated the results compared with the other devices, and ultrasound pachymetry was unmeasurable in six (13%) eyes with very thick and opaque corneas. In eyes with mild corneal edema (CCT 551–650 μm), measurements from the four devices were comparable.

          Conclusion

          All devices reliably measured the CCT <650 μm. In eyes with edema exceeding 650 μm, CCT measurements from the Visante OCT, Cirrus OCT, and ultrasound pachymetry devices showed good reproducibility and were well correlated, while the Pentacam overestimated the values compared to the other devices. Pentacam and ultrasound pachymetry should not be used in eyes with extreme corneal edema and opacity.

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          Repeatability and reproducibility of central corneal thickness measurement with Pentacam, Orbscan, and ultrasound.

          Gerald Schmidinger, S Pieh, C Skorpik … (2005)
          The purpose of this study was to compare central corneal thickness (CCT) measurements obtained with a novel rotating Scheimpflug camera (Pentacam; Oculus) with scanning slit topography (Orbscan; Bausch & Lomb), and with ultrasound pachymetry (SP-2000; Tomey). CCT in 30 healthy eyes was measured twice with each modality by 2 independent observers in random order. The results from scanning slit topography are given both with and without multiplication with the "acoustic correction factor" of 0.92. In addition, the displayed images from the rotating Scheimpflug camera and scanning slit topography were used to calculate the signal difference-to-noise ratios (SD/N) between cornea and background signal. The mean CCT values as determined with the different modalities (+/-standard deviation) were: 542+/-29 microm, 576+/-37 microm, 530+/-34 microm, and 552+/-32 microm for rotating Scheimpflug imaging, for uncorrected and for corrected scanning slit pachymetry, and for ultrasound, respectively. The differences between modalities (+/-95% limits of agreement) were -9.8+/-31 microm between rotating Scheimpflug and ultrasound, 24+/-31.2 microm between scanning slit and ultrasound, and 33+/-27 microm between scanning slit and rotating Scheimpflug imaging. The limits of agreement for within and between observer effects were within 4.2% of the absolute CCT values for scanning slit and ultrasound and within 2.2% for the rotating Scheimpflug imaging. The rotating Scheimpflug camera showed similar SD/N ratios but steeper edges of the corneal surfaces in the intensity profile plots. In the assessment of normal corneas, the Pentacam measured CCT values closer to ultrasound pachymetry and with less variability compared with Orbscan. The (interobserver) reproducibility with the Pentacam was highest of all 3 modalities.
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            Reproducibility and repeatability of central corneal thickness measurement in keratoconus using the rotating Scheimpflug camera and ultrasound pachymetry.

            Ugo de Sanctis, Alessandro Missolungi, Bernardo Mutani … (2007)
            To assess repeatability, reproducibility, and agreement of rotating Scheimpflug camera (Pentacam Oculus, Wetzlar, Germany) and ultrasound pachymetry in measuring central thickness of keratoconic corneas. Method-comparison study. In 33 patients with keratoconus (one eye per patient), two examiners each used both pachymetric methods to measure central corneal thickness (CCT); in the same session, measurements then were repeated by examiner 1 (A.M.). The difference between two examiners, and between first and second measurements by examiner 1, with both methods and the difference between the two pachymetric methods in measuring central thickness of keratoconic corneas were noted. With the rotating Scheimpflug camera, interexaminer correlation was higher (intra-class correlation coefficient [ICC], 0.98 vs 0.76) and inter-examiner variability was lower (95% limits of agreement [95% LoA], -14.8 to 13.8 microm vs -18.0 to +49.5 microm) than with ultrasound pachymetry. Both methods showed close first- to second-measurement correlation (ICC, > 90), but the rotating Scheimpflug camera had lower variability (95% LoA, -14.5 to 14.2 microm vs -27.4 to 26.0 microm). Mean CCT was 478.9 +/- 34.6 microm with the rotating Scheimpflug camera and 486.6 +/- 30 microm with ultrasound pachymetry. Although the mean difference was small (-7.8 microm), the 95% LoA (-43.8 to 28.2 microm) showed that the difference between the two methods can be considerable. In keratoconic corneas, the rotating Scheimpflug camera provides measurements of central thickness that are more reproducible and repeatable than those obtained with ultrasound pachymetry. The rotating Scheimpflug camera seems to be suitable for disease staging and follow-up, when corneal thickness measurements may be repeated over time by different examiners.
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              Central corneal thickness measurements with Fourier-domain optical coherence tomography versus ultrasonic pachymetry and rotating Scheimpflug camera.

              Taiji Nagaoka, Kazuomi Hanada, A Ishibazawa … (2011)
              To compare the accuracy and repeatability of Fourier-domain optical coherence tomography (FD-OCT) with ultrasonic pachymetry (USP) and a rotating Scheimpflug camera for measuring the central corneal thickness (CCT). The CCT was measured in 30 subjects (30 normal corneas) by the same examiner using RTVue-100 FD-OCT with an anterior segment adaptor, Pentacam rotating Scheimpflug camera, and SP-2000 USP. Two examiners obtained one FD-OCT measurement from 10 eyes of 5 subjects to assess interexaminer reproducibility. The mean CCT (±SD) measured by FD-OCT, USP, and the Pentacam were 530 ± 33, 544 ± 34, and 552 ± 35 μm, respectively. Significant correlations were found between FD-OCT and USP (r = 0.97; P < 0.0001), FD-OCT and Pentacam (r = 0.97; P < 0.0001), and USP and Pentacam (r = 0.96; P < 0.0001). Pairwise comparisons showed that the FD-OCT CCT measurement was significantly thinner than those of the other 2 methods (P < 0.001 for all comparisons). Regarding intraexaminer repeatability, the intraclass correlation coefficients ranged between 0.97 and 0.98. There was high repeatability of the CCT measurements with all methods. FD-OCT also had high interexaminer reproducibility (intraclass correlation coefficient = 0.98). RTVue-100 FD-OCT may be a useful alternative for measuring the CCT; however, it significantly underestimates the CCT compared with the USP and the Pentacam with slight differences. Although highly correlated, the measurements are not directly interchangeable in clinical practice.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Clin Ophthalmol
                Journal ID (iso-abbrev): Clin Ophthalmol
                Journal ID (publisher-id): Clinical Ophthalmology
                Title: Clinical Ophthalmology (Auckland, N.Z.)
                Publisher: Dove Medical Press
                ISSN (Print): 1177-5467
                ISSN (Electronic): 1177-5483
                Publication date Collection: 2018
                Publication date (Electronic): 25 September 2018
                Volume: 12
                Pages: 1865-1873
                Affiliations
                [1 ]Department of Ophthalmology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand, pinnita.pra@ 123456mahidol.edu
                [2 ]Department of Ophthalmology, Golden Jubilee Medical Center, Mahidol University, Nakhon Pathom, Thailand
                Author notes
                Correspondence: Pinnita Prabhasawat, Department of Ophthalmology, Faculty of Medicine, Siriraj Hospital, Mahidol University, 2 Prannok Road, Bangkoknoi, Bangkok 10700, Thailand, Tel +66 2 419 8037, Fax +66 2 411 2006, Email pinnita.pra@ 123456mahidol.edu
                Article
                Publisher ID: opth-12-1865
                DOI: 10.2147/OPTH.S172159
                PMC ID: 6165728
                PubMed ID: 30310265
                SO-VID: a1d45552-143f-4ee5-a0af-6c8dbfbff745
                Copyright © © 2018 Wongchaisuwat et al. This work is published and licensed by Dove Medical Press Limited
                License:

                The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.

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                Categories
                Subject: Original Research

                ScienceOpen disciplines: Ophthalmology & Optometry
                Keywords: central corneal thickness,ultrasonography,optical coherence tomography,scheimpflug camera tomography
                Data availability:
                ScienceOpen disciplines: Ophthalmology & Optometry
                Keywords: central corneal thickness, ultrasonography, optical coherence tomography, scheimpflug camera tomography

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