title: Assessment of lower tear meniscus measurements obtained with Keratograph and agreement with Fourier-domain optical-coherence tomography.
abstract: OBJECTIVE
  To compare intraobserver repeatability and interobserver and intersession reproducibility of lower tear meniscus height measurements (LTMH) obtained with the new Keratograph 5M and a Fourier-domain optical-coherence tomography (OCT; Spectralis OCT) and to assess the agreement between the two devices.
  
  
  METHODS
  This is a observational cross-sectional study. Thirty eyes of 30 normal subjects were randomly imaged twice with both devices in our setting. Two examiners randomly made LTMH measurements using the devices. To assess intraobserver repeatability and interobserver and intersession reproducibility within-subject SD (Sw), test-retest repeatability, coefficient of variation (CoV) and intraclass correlation coefficients (ICCs) were calculated. Agreement between both devices was also determined.
  
  
  RESULTS
  Average LMTH for Keratograph was 235.46±57.61 μm, whereas the mean LTMH measured by OCT was 245.84±67.18 μm. Intraobserver repeatability and interobserver and intersession reproducibility were moderate with Keratograph (CoV ≥0.16%, ≥0.19%, ≥0.17% and ICC ≤0.83, ≤0.76, ≤0.83, respectively) and high for the Spectralis OCT (CoV ≤0.13%, ≤0.12%, ≤0.11% and ICC ≥0.9, ≥0.92, ≥0.92, respectively). No statistically significant difference was detected in mean LMTH measurements made with both devices, although correlation was low (CoV 0.25%, ICC 0.55).
  
  
  CONCLUSIONS
  Spectralis OCT LTMH measurements were more reliable than the new Keratograph data. Agreement between the devices was poor.
authors: Servicio de Oftalmología, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain.
authors: Pedro
authors: P
authors: Arriola-Villalobos
authors: Servicio de Oftalmología, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain.
authors: José Ignacio
authors: JI
authors: Fernández-Vigo
authors: Servicio de Oftalmología, Departamento de Oftalmología y ORL, Facultad de Medicina, Hospital Clínico San Carlos, Universidad Complutense de Madrid, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain.
authors: David
authors: D
authors: Díaz-Valle
authors: Servicio de Oftalmología, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain.
authors: Jorge E
authors: JE
authors: Peraza-Nieves
authors: Servicio de Medicina Preventiva y Salud Pública, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain.
authors: Cristina
authors: C
authors: Fernández-Pérez
authors: Servicio de Oftalmología, Departamento de Oftalmología y ORL, Facultad de Medicina, Hospital Clínico San Carlos, Universidad Complutense de Madrid, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain Cooperative Research Network on Age-Related Ocular Pathology, Visual and Life Quality, Instituto de Salud Carlos III, Madrid, Spain.
authors: José M
authors: JM
authors: Benítez-Del-Castillo
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D003430:Cross-Sectional Studies; D003941:Diagnostic Techniques, Ophthalmological / Q000295:instrumentation; D064368:Healthy Volunteers; D015588:Observer Variation; D011446:Prospective Studies; D015203:Reproducibility of Results; D013666:Tears / Q000737:chemistry; D041623:Tomography, Optical Coherence / Q000295:instrumentation
keywords: Tears