Lower Tear Meniscus Measurements Using a New Anterior Segment Swept-Source Optical Coherence Tomography and Agreement With Fourier-Domain Optical Coherence Tomography

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To assess intraobserver repeatability and interobserver and intersession reproducibility of lower tear meniscus height (LTMH) measurements obtained using a new anterior segment swept-source optical coherence tomography (SS-OCT) device. Agreement with Fourier-domain (FD) OCT (Spectralis) was also examined.


In an observational cross-sectional study, one eye of 29 healthy subjects was randomly imaged with both devices at our center. Two examiners then randomly measured the LTMH using the software's calipers. To assess intraobserver repeatability and interobserver and intersession reproducibility, within-subject standard deviation (Sw), test–retest repeatability, coefficients of variation (CoV), and intraclass correlation coefficients (ICCs) were calculated. Agreement between both devices was also determined in Bland–Altman plots.


Mean LTMHs for SS-OCT and FD-OCT were 276.6 ± 87.6 and 280.3 ± 80 μm, respectively. Using the SS-OCT device, intraobserver CoV, interobserver CoV, and intersession CoV were found to be ≥16.9%, ≤7.2%, and ≤11.5%, respectively. ICCs for these parameters were ≤88%, ≥97%, and ≥94%, respectively. Bland–Altman analysis indicated poor agreement between SS-OCT and FD-OCT, and the correlation was low (CoV 34.5%, ICC 0.36).


SS-OCT LTMH measurements showed excellent interobserver and intersession repeatability along with good intraobserver reproducibility. Agreement between the devices was poor.

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