Interexaminer Reproducibility of Optical Coherence Tomography for Measuring the Tear Film Meniscus

Abstract

Purpose: New optical coherence tomography (OCT) devices with anterior segment module are able to measure the tear meniscus height (TMH) and tear meniscus area (TMA). Since the borders of the area and the height are to be marked by an examiner, the measurements are prone to be subjective. Herein, we aimed to evaluate the interexaminer reproducibility of the tear meniscus measurements with OCT.

Materials and Methods: In this prospective cross-sectional study, both eyes of 300 consecutive patients with and without dry eye were studied. Following routine ophthalmologic examination, tear-film OCT images were obtained. Two examiners, who were unaware of the other examiner’s results, measured the TMH (i.e. the line connecting the intersection of the meniscus with the cornea/sclera and eyelid) and cross-sectional TMA. The reliability and correlation of the two examiners’ results were assessed.

Results: Four right and six left eyes were excluded from the final analysis, so a total of 590 eyes were evaluated. The mean difference of the two examiners’ measurements of both eyes was −0.001 ± 0.027 mm² in TMA, and −21.29 ± 39.95 μm in TMH. An agreement between the two examiners was found regarding TMA and TMH measurements for right and left, as well as both eyes (Cronbach’s alpha > 0.900, for all). Also, the correlation between both variables was high (inter item correlation matrix > 0.840, for all).

Conclusions: We showed a strong statistical agreement for both TMA and TMH measurements. According to our results, we believe that FD-OCT device is dependable in measuring the TMA and TMH values, given that its results are reproducible.

• Dry eye syndromes
• optical coherence tomography
• optical imaging
• tears
• tear meniscus

Acknowledgements

We would like to thank M. Mustafa Koc for capturing the anterior segment OCT images (as examiner #1). We also would like to thank Cagla Sariturk for statistical evaluation of the results.