September 2016
Volume 57, Issue 12
Open Access
ARVO Annual Meeting Abstract  |   September 2016
Can we determine the true central corneal thickness? The significance of the discrepancy between the ultrasound and optical coherence tomography pachymetry
Author Affiliations & Notes
  • Magdalena Niestrata-Ortiz
    Edinburgh University, London, United Kingdom
  • Olivia Li
    Moorfields Eye Hospital, London, United Kingdom
  • Martin Haywood
    Chelsea and Westminster Hospital, London, United Kingdom
  • Nigel Davies
    Chelsea and Westminster Hospital, London, United Kingdom
  • Footnotes
    Commercial Relationships   Magdalena Niestrata-Ortiz, None; Olivia Li, None; Martin Haywood, None; Nigel Davies, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science September 2016, Vol.57, 1918. doi:
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      Magdalena Niestrata-Ortiz, Olivia Li, Martin Haywood, Nigel Davies; Can we determine the true central corneal thickness? The significance of the discrepancy between the ultrasound and optical coherence tomography pachymetry. Invest. Ophthalmol. Vis. Sci. 2016;57(12):1918.

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      © 2017 Association for Research in Vision and Ophthalmology.

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Abstract

Purpose : Central corneal thickness (CCT) plays an important role in the diagnostic and therapeutic assessment of ocular pathologies. The aim of the study was to assess the comparability of central corneal thickness measurements by optical coherence tomography (OCT) and ultrasound pachymetry and to determine their reliability and interchangeability as clinical tools. Based on the universal use of both methods in clinical practice, we hypothesised there would be no significant difference between the measurements.

Methods : We compared measurements by Optovue RTvue-100 optical coherence tomography (OCT) and Pachmate ultrasound (US). The data for OCT pachymetry was collected prospectively for 112 glaucoma and glaucoma suspect patients over a 5 month period. Using Bland-Altman plots, this was compared with retrospectively collected data on previously performed ultrasound pachymetry for the same patients. The statistical tools used in the data analysis included standard deviation, standard error and confidence intervals.

Results : A statistically significant difference was shown between pachymetry results obtained by US and OCT, with the mean difference of 26.00µm (standard error 1.72; standard deviation 18.19) and 31.13µm (standard error 1.84; standard deviation 19.39) and the 95% confidence interval of ± 3.41µm and ± 3.65µm for the right and left eye, respectively. The absolute measurement difference between the two methods was 0-135µm and 0-100µm for the right and left eye, respectively.

Conclusions : No gold standard exists for CCT measurement. Higher US thickness may be due to off-centre readings, exacerbated by Bell’s reflex. As CCT impacts corrected intraocular pressures and monitoring corneal endothelial failure, we challenge the interchangeable use of US and OCT pachymetry in clinical settings.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.

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