Comparison of corneal and lens density measurements obtained by Pentacam and CASIA2 in myopes

PURPOSE: To investigate the agreement between Pentacam and CASIA2 in the evaluation of corneal densities (CDs) and lens densities (LDs) in myopes. METHODS: Fifty-three patients (106 eyes) underwent comprehensive ophthalmologic examinations. CDs and LDs were measured using Pentacam and CASIA2, respectively, based on the grayscale percentage of the obtained images. Agreement between Pentacam and CASIA2 was evaluated using the consistency intraclass correlation coefficient (ICC) and represented using Bland-Altman plots. RESULTS: Compared to Pentacam, CASIA2 showed significantly higher CD and LD values in all measured zones. The ICC of the average CD and LD measured by the Pentacam and CASIA2 were 0.726 and 0.757, respectively. The ICC values of all corneal zones and lenses were above 0.7, except for the measurement of the cornea in the 0–2 mm zone (0.455), suggesting good consistency between the two devices, whose results were of different levels of linear correlation. Bland-Altman plots showed mean percentages of 3.93% for the points falling outside the limits of agreement among the densitometry results. The ICCs in different age groups were similar, but the agreement was poorer in the high myopia group (low and moderate myopia, CD: 0.739, LD: 0.753; high myopia, CD: 0.621, LD: 0.760). CONCLUSIONS: CASIA2 demonstrated good consistency with Pentacam in the measurement of CD and LD, except for measurement of CD in the central cornea and in high myopia. Despite difference in the numerical results compared with Pentacam, which made the two devices uninterchangeable, CASIA2 provides a reliable alternative densitometric measurement method. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12886-023-03199-3.