title: Reproducibility of cornea measurements in anterior segment OCT images of normal eyes and eyes with bullous keratopathy analyzed with the Zhongshan Assessment Program.
abstract: OBJECTIVE
  To determine the interobserver and intraobserver measurement reproducibility of cornea parameters of both normal eyes and eyes with bullous keratopathy (BK) obtained with the Zhongshan Assessment Program (ZAP) on anterior segment optical coherence tomography (AS-OCT) images.
  
  
  METHODS
  A comparative study was carried out on 24 healthy volunteers and 25 subjects with BK. AS-OCT images were independently analyzed by two examiners. Parameters examined: anterior chamber depth (ACD), central corneal thickness (CCT), posterior corneal curvature (PCC), and posterior corneal arc length (PCAL). Interobserver and intraobserver reproducibility of these parameters was calculated in terms of limits of agreement (mean of differences ± 1.96SD of differences).
  
  
  RESULTS
  In the normal group, both horizontal and vertical ACD were successfully measured in 23 of 24 (96%) images. The mean bias for two measurements by two different observers ranged from 0.003 to 0.117 mm for ACD, PCC, and PCAL measurements and from 0.013 to 2.25 μm for CCT measurements, and there were no differences between the two observers (P > 0.05). Mean bias for two measurements by the same grader ranged from 0.005 to 0.327 mm for ACD, PCC, and PCAL measurements and 1.46 to 2.53 μm for CCT measurements. There was no difference between the two observations (P > 0.05). Similar results were found in the BK group.
  
  
  CONCLUSIONS
  There was high inter- and intraobserver reproducibility for normal and pathologic corneas using the ZAP software. The ZAP software may serve as a new investigatory tool for accurately evaluating the anterior segment and corneal parameters for corneal procedures.
authors.affiliation: Singapore Eye Research Institute, Singpore.
authors.forename: Joy B
authors.initials: JB
authors.lastname: Chan
authors.forename: Leonard H
authors.initials: LH
authors.lastname: Yuen
authors.forename: Elaine H
authors.initials: EH
authors.lastname: Huang
authors.forename: Hla M
authors.initials: HM
authors.lastname: Htoon
authors.forename: Mingguang
authors.initials: M
authors.lastname: He
authors.forename: Tin
authors.initials: T
authors.lastname: Aung
authors.forename: Donald T
authors.initials: DT
authors.lastname: Tan
authors.forename: Jodhbir S
authors.initials: JS
authors.lastname: Mehta
mesh_terms: D000328:Adult; D000867:Anterior Chamber / Q000033:anatomy & histology; D000869:Anterior Eye Segment / Q000473:pathology*; D001768:Blister / Q000473:pathology*; D003315:Cornea / Q000473:pathology*; D003316:Corneal Diseases / Q000473:pathology*; D003936:Diagnosis, Computer-Assisted / Q000592:standards / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D015203:Reproducibility of Results; D012984:Software / Q000592:standards; D041623:Tomography, Optical Coherence / Q000379:methods / Q000592:standards* / Q000706:statistics & numerical data; D055815:Young Adult