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Reproducibility of angle metrics in children using hand‐held spectral domain optical coherence tomography: intra‐observer and inter‐observer variability
Author(s) -
Edawaji B.,
Shah S.,
Proudlock F.,
Gottlob I.
Publication year - 2017
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/j.1755-3768.2017.01128
Subject(s) - reproducibility , anterior chamber angle , optical coherence tomography , intraclass correlation , nuclear medicine , medicine , ophthalmology , gonioscopy , mathematics , glaucoma , optics , physics , statistics
Purpose To evaluate intraobserver and interobserver agreements of anterior chamber angle measurements in children using hand‐held spectral domain optical coherence tomography ( HH ‐ SDOCT ). Methods HH ‐ SDOCT (Leica Microsystems Ltd) was used to scan the anterior chamber of 30 normal children (mean age = 5.12 ± 3.5 years, range: 2 days to 12 years). Two independent observers analysed the same B‐scan showing both clear nasal and temporal angles using ImageJ. They identified iridocorneal angle landmarks: scleral spur ( SS ), Schwalbe`s line ( SL ) and angle recess ( AR ) and used them to calculate parameters such as trabecular meshwork length ( TML ), SS angle opening distance ( SSAOD ), SL angle opening distance ( SLAOD ), SL angle ( SLA ), SS limbal distance ( SSLD ), SL limbal distance ( SLLD ), trabecular iris surface area ( TISA 500), nasal to temporal SS distance ( SS ‐ SSD ) and pupil diameter ( PD ). The reproducibility of measurements were assessed using interclass correlation coefficients ( ICC ) and Bland‐Altman plots. Results Repeated measurements of anterior chamber were calculated in 141 images. Both intra‐observer and inter‐observer agreements of most measurements ranged from fair to excellent (0.66 to 0.97). Intra‐observer and inter‐observer ICC for SSAOD , SLAOD , SLA , SSLD , SLLD , TISA 500, SS ‐ SSD and PD were 0.74, 0.78, 0.81, 0.72, 0.80, 0.76, 0.96, 0.96 and 0.83, 0.85, 0.77, 0.91, 0.89, 0.83, 0.84, 0.97, respectively. TML reproducibility was poor, ICC were 0.42 and 0.33, respectively. Bland Altman plots showed no significant difference between repeated measurements (p value were >0.05) for parameters with ICC reproducibility ≥0.7. Conclusions Reproducible quantitative measurements in children using HH ‐ SDOCT was possible with ICC of up to 0.97. Anterior segment OCT could be a potential method in understanding the normal and abnormal ocular development of children.