Dependence of dynamic contour and Goldmann applanation tonometries on peripheral corneal thickness

AIM：To determine the effects of peripheral corneal thickness（PCT）on dynamic contour tonometry（DCT）and Goldmann applanation tonometry（GAT）.METHODS：A cross-sectional study.We created a software which calculates the corneal contour（CC）as a function of the radius from the corneal apex to each pixel of the contour.The software generates a central circumference with a radius of 1 mm and the remainder of the cornea is segmented in 5 rings concentric with corneal apex being its diameter not constant around the corneal circumference as a consequence of the irregular CC but keeping constant the diameter of each ring in each direction of the contour.PCT was determined as the mean thickness of the most eccentric ring.Locally weighted scatterplot smoothing（LOWESS）regression was used to determine the pattern of the relationship between PCT and both DCT and GAT respectively.Thereafter,two multivariable linear regression models were constructed.In each of them,the dependant variable was intraocular pressure（IOP）as determined using GAT and DCT respectively.In both of the models the predictive variable was PCT though LOWESS regression pattern was used to model the relationship between the dependant variables and the predictor one.Age and sex were also introduced control variables along with their first-degree interactions with PCT.Main outcome measures include amount of IOP variation explained through regression models（R2）and regression coefficients（B）.RESULTS：Subjects included 109 eyes of 109 healthy individuals.LOWESS regression suggested that a 2nd-degree polynomial would be suitable to model the relationshipbetween both DCT and GAT with PCT.Hence PCT was introduced in both models as a linear and quadratic term.Neither age nor sex nor interactions were statistically significant in both models.For GAT model,R2was 17.14%（F=9.02;P=0.0002）,PCT linear term B was-1.163（95%CI：-1.163,-0.617）.PCT quadratic term B was 0.00081（95%CI：0.00043,0.00118）.For DCT model R2was 14.28%（F=9.29;P=0.0002）,PCT linear term B was-0.712（95%CI：-1.052,-0.372）,PCT quadratic term was B=0.0005（95%CI：0.0003,0.0007）.CONCLUSION：DCT and GAT measurements are conditioned by PCT though this effect,rather than linear,follows a2nd-degree polynomial pattern.

The precision and agreement of corneal thickness and keratometry measurements with SS-OCT versus Scheimpflug imaging

Purpose:To assess the repeatability and reproducibility of swept-source optical coherence tomography(SS-OCT)and Scheimpflug system and evaluate the agreement between the two systems in measuring multiple corneal regions in children.Methods:Pachymetric and keratometric maps for both systems were evaluated.Central,midperipheral and peripheral corneal thickness(CT),keratometry and astigmatism power vectors were recorded.The three outcomes yielded by the same observer were used to assess intraobserver repeatability.The differences in the mean values provided by each observer were used to evaluate interobserver reproducibility.Within-subject standard deviation,test-retest repeatability(TRT)and coefficient of variation(CoV)were used to analyze the intraobserver repeatability and interobserver reproducibility.Paired T-test and Bland-Altman were used to appraise interdevice agreement.Results:Seventy-eight eyes of 78 children were included.The CoV was≤2.12 and 1.10%,respectively,for repeatability and reproducibility.TRT and CoV were lower for central and paracentral CT measurements than for peripheral measurements.The SS-OCT device generated higher precision when acquiring CT data,whereas Scheimpflug system showed higher reliability when measuring corneal keratometry.Although the CT readings measured using SS-OCT were significantly thinner than Scheimpflug device(P<0.001),the central and thinnest CT values were still of high agreement.The interdevice agreement of keratometry measurement was high for the central corneal region and moderate for the paracentral and peripheral areas.Conclusions:The precision of CT measurements by SS-OCT was higher,while the reliability of keratometry measurements by the Scheimpflug system was higher in children.Apart from the measured values in the central corneal region,the thickness and keratometry readings should not be considered interchangeable between the two systems.

The precision and agreement of corneal thickness and keratometry measurements with SS-OCT versus Scheimpflug imaging

Purpose:To assess the repeatability and reproducibility of swept-source optical coherence tomography(SS-OCT)and Scheimpflug system and evaluate the agreement between the two systems in measuring multiple corneal regions in children.Methods:Pachymetric and keratometric maps for both systems were evaluated.Central,midperipheral and peripheral corneal thickness(CT),keratometry and astigmatism power vectors were recorded.The three outcomes yielded by the same observer were used to assess intraobserver repeatability.The differences in the mean values provided by each observer were used to evaluate interobserver reproducibility.Within-subject standard deviation,test-retest repeatability(TRT)and coefficient of variation(CoV)were used to analyze the intraobserver repeatability and interobserver reproducibility.Paired T-test and Bland-Altman were used to appraise interdevice agreement.Results:Seventy-eight eyes of 78 children were included.The CoV was≤2.12 and 1.10%,respectively,for repeatability and reproducibility.TRT and CoV were lower for central and paracentral CT measurements than for peripheral measurements.The SS-OCT device generated higher precision when acquiring CT data,whereas Scheimpflug system showed higher reliability when measuring corneal keratometry.Although the CT readings measured using SS-OCT were significantly thinner than Scheimpflug device(P<0.001),the central and thinnest CT values were still of high agreement.The interdevice agreement of keratometry measurement was high for the central corneal region and moderate for the paracentral and peripheral areas.Conclusions:The precision of CT measurements by SS-OCT was higher,while the reliability of keratometry measurements by the Scheimpflug system was higher in children.Apart from the measured values in the central corneal region,the thickness and keratometry readings should not be considered interchangeable between the two systems.