Purpose: To investigate the repeatability and reproducibility of mapping the entire corneal thickness using spectral domain optical coherence tomography (SD-OCT). Methods: Thirty normal eyes, 30 post-laser in situ keratomileusis (LASIK) surgery eyes, and 30 keratoconus eyes were analyzed. A custom-built long scan depth SD-OCT device was used to obtain entire corneal images. Ten-millimeter-diameter corneal thickness maps were generated by an automated segmentation algorithm. Intraclass correlation coefficients of repeatability (ICC1) and reproducibility (ICC2), and coefficients of repeatability (CoR1) and reproducibility (CoR2), were calculated to quantify the precision and accuracy of corneal pachymetry measurements using the Bland-Altman method. Results: For SD-OCT measurements in healthy subjects, CoR1 and CoR2 were less than 5.00 and 5.53 μm. ICC1 and ICC2 were more than 0.997 and 0.996. For SD-OCT measurements in LASIK patients, CoR1 and CoR2 were less than 5.09 and 5.34 μm. ICC1 and ICC2 were more than 0.997 and 0.996. For SD-OCT measurements in keratoconus patients, CoR1 and CoR2 were less than 11.57 and 10.92 μm. ICC1 and ICC2 were more than 0.995 and 0.996. Conclusions: The measurements of corneal pachymetric mapping by long scan depth SD-OCT can be assessed over the entire corneal area with good repeatability and reproducibility.

1.
Martin R, de Juan V, Rodriguez G, Cuadrado R, Fernandez I: Measurement of corneal swelling variations without removal of the contact lens during extended wear. Invest Ophthalmol Vis Sci 2007;48:3043-3050.
2.
Brandt JD, Beiser JA, Gordon MO, Kass MA: Central corneal thickness and measured IOP response to topical ocular hypotensive medication in the Ocular Hypertension Treatment Study. Am J Ophthalmol 2004;138:717-722.
3.
Dutta D, Rao HL, Addepalli UK, Vaddavalli PK: Corneal thickness in keratoconus: comparing optical, ultrasound, and optical coherence tomography pachymetry. Ophthalmology 2013;120:457-463.
4.
Li Y, Meisler DM, Tang M, Lu AT, Thakrar V, Reiser BJ, Huang D: Keratoconus diagnosis with optical coherence tomography pachymetry mapping. Ophthalmology 2008;115:2159-2166.
5.
Randleman JB, Woodward M, Lynn MJ, Stulting RD: Risk assessment for ectasia after corneal refractive surgery. Ophthalmology 2008;115:37-50.
6.
Ou RJ, Shaw EL, Glasgow BJ: Keratectasia after laser in situ keratomileusis (LASIK): evaluation of the calculated residual stromal bed thickness. Am J Ophthalmol 2002;134:771-773.
7.
Marsich MW, Bullimore MA: The repeatability of corneal thickness measures. Cornea 2000;19:792-795.
8.
Miglior S, Albe E, Guareschi M, Mandelli G, Gomarasca S, Orzalesi N: Intraobserver and interobserver reproducibility in the evaluation of ultrasonic pachymetry measurements of central corneal thickness. Br J Ophthalmol 2004;88:174-177.
9.
Barkana Y, Gerber Y, Elbaz U, Schwartz S, Ken-Dror G, Avni I, Zadok D: Central corneal thickness measurement with the Pentacam Scheimpflug system, optical low-coherence reflectometry pachymeter, and ultrasound pachymetry. J Cataract Refract Surg 2005;31:1729-1735.
10.
Bechmann M, Thiel MJ, Neubauer AS, Ullrich S, Ludwig K, Kenyon KR, Ulbig MW: Central corneal thickness measurement with a retinal optical coherence tomography device versus standard ultrasonic pachymetry. Cornea 2001;20:50-54.
11.
Huang J, Pesudovs K, Yu A, Wright T, Wen D, Li M, Yu Y, Wang Q: A comprehensive comparison of central corneal thickness measurement. Optom Vis Sci 2011;88:940-949.
12.
Ishibazawa A, Igarashi S, Hanada K, Nagaoka T, Ishiko S, Ito H, Yoshida A: Central corneal thickness measurements with Fourier-domain optical coherence tomography versus ultrasonic pachymetry and rotating Scheimpflug camera. Cornea 2011;30:615-619.
13.
Nam SM, Im CY, Lee HK, Kim EK, Kim TI, Seo KY: Accuracy of RTVue optical coherence tomography, Pentacam, and ultrasonic pachymetry for the measurement of central corneal thickness. Ophthalmology 2010;117:2096-2103.
14.
Huang D, Swanson EA, Lin CP, Schuman JS, Stinson WG, Chang W, Hee MR, Flotte T, Gregory K, Puliafito CA: Optical coherence tomography. Science 1991;254:1178-1181.
15.
Prakash G, Agarwal A, Mazhari AI, Chari M, Kumar DA, Kumar G, Singh B: Reliability and reproducibility of assessment of corneal epithelial thickness by Fourier domain optical coherence tomography. Invest Ophthalmol Vis Sci 2012;53:2580-2585.
16.
Schmoll T, Unterhuber A, Kolbitsch C, Le T, Stingl A, Leitgeb R: Precise thickness measurements of Bowman's layer, epithelium, and tear film. Optom Vis Sci 2012;89:E795-E802.
17.
Tao A, Wang J, Chen Q, Shen M, Lu F, Dubovy SR, Shousha MA: Topographic thickness of Bowman's layer determined by ultra-high resolution spectral domain-optical coherence tomography. Invest Ophthalmol Vis Sci 2011;52:3901-3907.
18.
Li Y, Tan O, Brass R, Weiss JL, Huang D: Corneal epithelial thickness mapping by Fourier-domain optical coherence tomography in normal and keratoconic eyes. Ophthalmology 2012;119:2425-2433.
19.
Christopoulos V, Kagemann L, Wollstein G, Ishikawa H, Gabriele ML, Wojtkowski M, Srinivasan V, Fujimoto JG, Duker JS, Dhaliwal DK, Schuman JS: In vivo corneal high-speed, ultra high-resolution optical coherence tomography. Arch Ophthalmol 2007;125:1027-1035.
20.
Yasuno Y, Madjarova VD, Makita S, Akiba M, Morosawa A, Chong C, Sakai T, Chan KP, Itoh M, Yatagai T: Three-dimensional and high-speed swept-source optical coherence tomography for in vivo investigation of human anterior eye segments. Opt Express 2005;13:10652-10664.
21.
Wang J, Abou SM, Perez VL, Karp CL, Yoo SH, Shen M, Cui L, Hurmeric V, Du C, Zhu D, Chen Q, Li M: Ultra-high resolution optical coherence tomography for imaging the anterior segment of the eye. Ophthalmic Surg Lasers Imaging 2011;42:S15-S27.
22.
Li Y, Tang M, Zhang X, Salaroli CH, Ramos JL, Huang D: Pachymetric mapping with Fourier-domain optical coherence tomography. J Cataract Refract Surg 2010;36:826-831.
23.
Sin S, Simpson TL: The repeatability of corneal and corneal epithelial thickness measurements using optical coherence tomography. Optom Vis Sci 2006;83:360-365.
24.
Prakash G, Agarwal A, Mazhari AI, Chari M, Kumar DA, Kumar G, Singh B: Reliability and reproducibility of assessment of corneal epithelial thickness by Fourier domain optical coherence tomography. Invest Ophthalmol Vis Sci 2012;53:2580-2585.
25.
Wang T, Shi W, Ding G, Li S, Liu M, Gao H: Ring-shaped corneoscleral lamellar keratoplasty guided by high-definition optical coherence tomography and Scheimpflug imaging for severe Terrien's marginal corneal degeneration. Graefes Arch Clin Exp Ophthalmol 2012;250:1795-1801.
26.
Panos GD, Hafezi F, Gatzioufas Z: Pellucid marginal degeneration and keratoconus; differential diagnosis by corneal topography. J Cataract Refract Surg 2013;39:968.
27.
Brautaset RL, Nilsson M, Miller WL, Leach NE, Tukler JH, Bergmanson JP: Central and peripheral corneal thinning in keratoconus. Cornea 2013;32:257-261.
28.
Prospero Ponce CM, Rocha KM, Smith SD, Krueger RR: Central and peripheral corneal thickness measured with optical coherence tomography, Scheimpflug imaging, and ultrasound pachymetry in normal, keratoconus-suspect, and post-laser in situ keratomileusis eyes. J Cataract Refract Surg 2009;35:1055-1062.
29.
Shen M, Wang MR, Yuan Y, Chen F, Karp CL, Yoo SH, Wang J: SD-OCT with prolonged scan depth for imaging the anterior segment of the eye. Ophthalmic Surg Lasers Imaging 2010;(41 suppl):S65-S69.
30.
Shen M, Cui L, Li M, Zhu D, Wang MR, Wang J: Extended scan depth optical coherence tomography for evaluating ocular surface shape. J Biomed Opt 2011;16:056007.
31.
Shen M, Wang MR, Wang J, Yuan Y, Chen F: Entire contact lens imaged in vivo and in vitro with spectral domain optical coherence tomography. Eye Contact Lens 2010;36:73-76.
32.
Ge L, Shen M, Tao A, Wang J, Dou G, Lu F: Automatic segmentation of the central epithelium imaged with three optical coherence tomography devices. Eye Contact Lens 2012;38:150-157.
33.
Ge L, Yuan Y, Shen M, Tao A, Wang J, Lu F: The role of axial resolution of optical coherence tomography on the measurement of corneal and epithelial thicknesses. Invest Ophthalmol Vis Sci 2013;54:746-755.
34.
Shen M, Cui L, Riley C, Wang MR, Wang J: Characterization of soft contact lens edge fitting using ultra-high resolution and ultra-long scan depth optical coherence tomography. Invest Ophthalmol Vis Sci 2011;52:4091-4097.
35.
Yuan Y, Chen F, Shen M, Lu F, Wang J: Repeated measurements of the anterior segment during accommodation using long scan depth optical coherence tomography. Eye Contact Lens 2012;38:102-108.
36.
Chiu SJ, Li XT, Nicholas P, Toth CA, Izatt JA, Farsiu S: Automatic segmentation of seven retinal layers in SDOCT images congruent with expert manual segmentation. Opt Express 2010;18:19413-19428.
37.
Larocca F, Chiu SJ, McNabb RP, Kuo AN, Izatt JA, Farsiu S: Robust automatic segmentation of corneal layer boundaries in SDOCT images using graph theory and dynamic programming. Biomed Opt Express 2011;2:1524-1538.
38.
Westphal V, Rollins A, Radhakrishnan S, Izatt J: Correction of geometric and refractive image distortions in optical coherence tomography applying Fermat's principle. Opt Express 2002;10:397-404.
39.
Ortiz S, Siedlecki D, Grulkowski I, Remon L, Pascual D, Wojtkowski M, Marcos S: Optical distortion correction in optical coherence tomography for quantitative ocular anterior segment by three-dimensional imaging. Opt Express 2010;18:2782-2796.
40.
Li Y, Shekhar R, Huang D: Corneal pachymetry mapping with high-speed optical coherence tomography. Ophthalmology 2006;113:792-799.
41.
Mohamed S, Lee GK, Rao SK, Wong AL, Cheng AC, Li EY, Chi SC, Lam DS: Repeatability and reproducibility of pachymetric mapping with Visante anterior segment-optical coherence tomography. Invest Ophthalmol Vis Sci 2007;48:5499-5504.
42.
Read SA, Collins MJ: Diurnal variation of corneal shape and thickness. Optom Vis Sci 2009;86:170-180.
43.
Bland JM, Altman DG: Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1986;1:307-310.
44.
Bland JM, Altman DG: Measurement error. BMJ 1996;313:744.
45.
Bartko JJ: The intraclass correlation coefficient as a measure of reliability. Psychol Rep 1966;19:3-11.
46.
Hamilton C, Lewis S: The importance of using the correct bounds on the Bland-Altman limits of agreement when multiple measurements are recorded per patient. J Clin Monit Comput 2010;24:173-175.
47.
Krachmer JH: Pellucid marginal corneal degeneration. Arch Ophthalmol 1978;96:1217-1221.
48.
Jinabhai A, Radhakrishnan H, O'Donnell C: Pellucid corneal marginal degeneration: a review. Cont Lens Anterior Eye 2011;34:56-63.
49.
Samy El Gendy NM, Li Y, Zhang X, Huang D: Repeatability of pachymetric mapping using Fourier domain optical coherence tomography in corneas with opacities. Cornea 2012;31:418-423.
50.
Vidal S, Viqueira V, Mas D, Domenech B: Repeatability and reproducibility of corneal thickness using SOCT Copernicus HR. Clin Exp Optom 2013;96:278-285.
51.
Huang JY, Pekmezci M, Yaplee S, Lin S: Intra-examiner repeatability and agreement of corneal pachymetry map measurement by time-domain and Fourier-domain optical coherence tomography. Graefes Arch Clin Exp Ophthalmol 2010;248:1647-1656.
52.
Neri A, Malori M, Scaroni P, Leaci R, Delfini E, Macaluso C: Corneal thickness mapping by 3D swept-source anterior segment optical coherence tomography. Acta Ophthalmol 2012;90:e452-e457.
53.
Wojtkowski M, Leitgeb R, Kowalczyk A, Bajraszewski T, Fercher AF: In vivo human retinal imaging by Fourier domain optical coherence tomography. J Biomed Opt 2002;7:457-463.
54.
Wojtkowski M, Kowalczyk A, Leitgeb R, Fercher AF: Full range complex spectral optical coherence tomography technique in eye imaging. Opt Lett 2002;27:1415-1417.
55.
Huang J, Ding X, Savini G, Pan C, Feng Y, Cheng D, Hua Y, Hu X, Wang Q: A comparison between Scheimpflug imaging and optical coherence tomography in measuring corneal thickness. Ophthalmology 2013;120:1951-1958.
56.
Reinstein DZ, Gobbe M, Archer TJ: Anterior segment biometry: a study and review of resolution and repeatability data. J Refract Surg 2012;28:509-520.
57.
Fukuda S, Kawana K, Yasuno Y, Oshika T: Anterior ocular biometry using 3-dimensional optical coherence tomography. Ophthalmology 2009;116:882-889.
58.
Nissen J, Hjortdal JO, Ehlers N, Frost-Larsen K, Sorensen T: A clinical comparison of optical and ultrasonic pachometry. Acta Ophthalmol (Copenh) 1991;69:659-663.
59.
Kawana K, Tokunaga T, Miyata K, Okamoto F, Kiuchi T, Oshika T: Comparison of corneal thickness measurements using Orbscan II, non-contact specular microscopy, and ultrasonic pachymetry in eyes after laser in situ keratomileusis. Br J Ophthalmol 2004;88:466-468.
60.
Memarzadeh F, Li Y, Francis BA, Smith RE, Gutmark J, Huang D: Optical coherence tomography of the anterior segment in secondary glaucoma with corneal opacity after penetrating keratoplasty. Br J Ophthalmol 2007;91:189-192.
61.
Khurana RN, Li Y, Tang M, Lai MM, Huang D: High-speed optical coherence tomography of corneal opacities. Ophthalmology 2007;114:1278-1285.
62.
Shankar H, Pesudovs K: Reliability of peripheral corneal pachymetry with the Oculus Pentacam. J Cataract Refract Surg 2008;34:7.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.