title: Comparison of anterior segment optical tomography parameters measured using a semi-automatic software to standard clinical instruments.
abstract: OBJECTIVE
  To compare anterior segment parameters measured using a semi-automatic software (Zhongshan Angle Assessment Program, ZAP) applied to anterior segment optical coherence tomography (AS-OCT) images, with commonly used instruments.
  
  
  METHODS
  Cross-sectional study of a total of 1069 subjects (1069 eyes) from three population-based studies of adults aged 40-80 years. All subjects underwent AS-OCT imaging and ZAP software was applied to determine anterior chamber depth (ACD), central corneal thickness (CCT), anterior and keratometry (K) - readings. These were compared to auto-refraction, keratometry and ocular biometry measured using an IOLMaster, ultrasound pachymeter and auto-refractor respectively. Agreements between AS-OCT (ZAP) and clinical instrument modalities were described using Bland-Altman, 95% limits of agreement (LOA).
  
  
  RESULTS
  The mean age of our subjects was 56.9±9.5 years and 50.9% were male. The mean AS-OCT (ZAP) parameters of our study cohort were: ACD 3.29±0.35 mm, CCT 560.75±35.07 µm; K-reading 46.79±2.72 D. There was good agreement between the measurements from ZAP analysis and each instrument and no violations in the assumptions of the LOA; albeit with a systematic bias for each comparison: AS-OCT consistently measured a deeper ACD compared to IOLMaster (95% LOA -0.24, 0.55); and a thicker CCT for the AS-OCT compared to ultrasound pachymetry (16.8±0.53 µm 95% LOA -17.3, 50.8). AS-OCT had good agreement with auto-refractor with at least 95% of the measurements within the prediction interval (P value <0.001).
  
  
  CONCLUSIONS
  This study demonstrates that there is good agreement between the measurements from the AS-OCT (ZAP) and conventional tools. However, small systematic biases remain that suggest that these measurement tools may not be interchanged.
authors.affiliation: Singapore National Eye Centre, Singapore, Singapore ; Singapore Eye Research Institute, Singapore, Singapore.
authors.forename: Marcus
authors.initials: M
authors.lastname: Ang
authors.forename: Wesley
authors.initials: W
authors.lastname: Chong
authors.forename: Huiqi
authors.initials: H
authors.lastname: Huang
authors.forename: Wan Ting
authors.initials: WT
authors.lastname: Tay
authors.forename: Tien Yin
authors.initials: TY
authors.lastname: Wong
authors.forename: Ming-Guang
authors.initials: MG
authors.lastname: He
authors.forename: Tin
authors.initials: T
authors.lastname: Aung
authors.forename: Jodhbir S
authors.initials: JS
authors.lastname: Mehta
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001331:Automation; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012015:Reference Standards; D012984:Software; D041622:Tomography, Optical / Q000295:instrumentation / Q000379:methods*