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Comparison of central corneal thickness measured by automatic and manual analysis of optical coherence tomography

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Abstract

Purpose

To compare central corneal thickness (CCT) measured with optical coherence tomography (OCT) using an automatic algorithm (A-OCT) vs. manual measurements (M-OCT) with respect to the gold standard ultrasound pachymetry (USP).

Methods

CCT measurements were performed on both eyes of 28 healthy subjects at four times of the day. A-OCT used an automatic software analysis of the corneal image, M-OCT was performed by two operators by setting a digital calliper on the corneal borders, and USP was performed after corneal anesthesia. Measurements were compared using a three-way repeated measures ANOVA. Bland–Altman plots were used to evaluate the agreement between OCT measurements and USP.

Results

Both A-OCT and M-OCT significantly underestimated the USP measures, with the mean difference, i.e., the systematic error, being larger for A-OCT (− 19.0 µm) than for M-OCT (− 6.5 µm). Good reproducibility between the two operators was observed. Bland–Altman plots showed that both OCT methods suffered from proportional errors, which were not affected by time and eye.

Conclusions

Measuring CCT with OCT yielded lower values than USP. Therefore, clinicians should be aware that corneal thickness values may be influenced by the measurement method and that the various devices should not be used interchangeably in following up a given patient. Intriguingly, M-OCT had less systematic error than A-OCT, an important outcome that clinicians should consider when deciding to use an OCT device.

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Acknowledgements

The authors would like to thank Dr. Martina Venturi for her support in collecting data.

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Authors and Affiliations

  1. University Eye Clinic, IRCCS, Policlinico San Matteo, Pavia, Italy

    Carlo Bruttini

  2. Eye Clinic, Melegnano Hospital, Via Pandina, 1, 20077, Vizzolo Predabissi, Italy

    Carlo Bruttini, Alfredo Pece & Giulio Maione

  3. Human Physiology Section of the DePT, Università Degli Studi Di Milano, Milan, Italy

    Roberto Esposti & Paolo Cavallari

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  1. Carlo Bruttini
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Corresponding author

Correspondence to Carlo Bruttini.

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Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the Fondazione IRCCS Policlinico San Matteo, Pavia, Italy, and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The study was approved by The Ethics Committee of the Fondazione IRCCS Policlinico San Matteo, Pavia, Italy (ID # n.20170001732).

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Bruttini, C., Esposti, R., Pece, A. et al. Comparison of central corneal thickness measured by automatic and manual analysis of optical coherence tomography. Graefes Arch Clin Exp Ophthalmol (2024). https://doi.org/10.1007/s00417-023-06354-0

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  • DOI: https://doi.org/10.1007/s00417-023-06354-0

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