Evaluation of Central Corneal Thickness Measurement With RTVue Spectral Domain Optical Coherence Tomography in Normal Subjects

Purpose: To determine (1) repeatability of central corneal thickness (CCT) measurements by spectral domain optical coherence tomography (RTVue; Optovue, Inc, Fremont, CA) and (2) agreement between CCT measurements by RTVue and those by ultrasonic pachymetry, Orbscan, and anterior segment optical coherence tomography (ASOCT). Methods: In a prospective observational study, 2 cohorts of normal subjects were recruited. In the first cohort (51 subjects), 5 measurements of CCT were obtained by RTVue during the same visit to determine the repeatability. In the second cohort (65 subjects), CCT measurements were obtained by RTVue, ultrasonic pachymetry, Orbscan, and ASOCT during the same visit to determine the agreement among these instruments. Repeatability was assessed by intraclass correlation coefficient (ICC), within-subject standard deviation, coefficient of repeatability, and within-subject coefficient of variation. Agreement was assessed by ICC and Bland and Altman plots. Results: Repeatability of CCT measurements by RTVue as assessed by ICC, within-subject standard deviation, coefficient of repeatability, and within-subject coefficient of variation was 0.99 (0.99-0.99), 2.2 (1.9-2.5), 4.2 mm (3.6-4.8), and 0.4% (0.3-0.5), respectively. The average CCT by RTVue (529 mu m) was comparable to that by ultrasonic pachymetry (539 mu m; P = 0.15), Orbscan (536 mu m; P = 0.54), and ASOCT (526 mu m; P = 0.77). The 95% limits of agreement on Bland and Altman plots ranged from 20 mm (between RTVue and ASOCT) to 33 mm (between RTVue and Orbscan). Conclusions: CCT measurements by RTVue have an excellent repeatability. Although CCT measurements by RTVue are comparable to that by ultrasonic pachymetry, Orbscan, and ASOCT, the difference between instruments can be significant depending on the clinical situation considered.