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 devices were 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.