Intradevice Repeatability and Interdevice Agreement of Ocular Biometric Measurements: A Comparison of Two Swept-Source Anterior Segment OCT Devices.

Purpose: To assess the repeatability and agreement of ocular biometric parameters measured using the Tomey CASIA SS-1000 and Heidelberg ANTERION anterior segment optical coherence tomography (AS-OCT) devices. Methods: Both eyes of subjects 18 years of age or older were scanned three times with the CASIA and ANTERION under standardized dark lighting. One AS-OCT image along the horizontal (temporal-nasal) meridian was analyzed per eye and per scan. Pupillary diameter (PD) was within 15% for all pairwise comparisons. Anterior chamber depth, lens vault, anterior chamber width, angle opening distance, trabecular iris space area, and scleral spur angle (SSA500) were measured using manufacturer-provided image analysis software. Intraclass correlation (ICC), Wilcoxon signed-rank, and Bland-Altman analyses were performed to assess intradevice repeatability and interdevice agreement of measurements. Results: Thirty-two eyes of 21 subjects were analyzed. There was excellent agreement (ICC>0.98) and no significant difference (P> 0.05) in PD across all comparisons. Intradevice measurement repeatability was excellent for both the CASIA (ICC range 0.93-0.99) and ANTERION (ICC range 0.97-0.99). Interdevice measurement agreement was also excellent (ICC range 0.85-0.96). Measurements within and between deviceswere similar (P > 0.06) for all parameters except SSA500 (P = 0.03). Linear regression and Bland-Altman plots showed the relationship was consistent across the entire range of measurements. Conclusions: Intradevice measurement repeatability is excellent for the CASIA and ANTERION. Interdevice measurement agreement between the two devices exceeds metrics reported by previous comparison studies. Translational Relevance: Modern swept-source AS-OCT devices produce highly repeatable measurements of ocular biometric parameters that are nearly interchangeable across devices.