Pachymetric mapping with Fourier-domain optical coherence tomography

Purpose: To evaluate the repeatability of Fourier-domain optical coherence tomography (OCT) pachymetric mapping and compare central corneal thickness (CCT) measurements by OCT, ultrasound pachymetry, and scanning-slit tomography. Setting: Doheny Eye Institute, University of Southern California, Los Angeles, California, USA. Methods: A Fourier-domain OCT system was used to map the corneal thickness in normal eyes with scans centered on the corneal vertex or the pupil. Repeatability of central and pericentral map sectors was assessed by pooled standard deviation. The CCT measurements were compared between the OCT, ultrasound, and scanning-slit devices. Results: Pupil centration (SD: 1.3 μm central, 1.8 to 3.8 μm pericentral) provided better repeatability than vertex centration (SD: 1.7 μm central, 2.4 to 5.7 μm pericentral) in all sectors (P<.035). The mean CCT was 536.9 μm ± 27.0 (SD) by OCT, 556.6 ± 30.5 μm by ultrasound, and 537.2 ± 32.6 μm by scanning-slit tomography (acoustic factor 0.92). The CCT measured by OCT was significantly thinner than by ultrasound pachymetry (P = .007; mean difference -19.7 μm; 95% limits of agreement [LoA], -40.4 to 0.9 μm) but not than by scanning-slit tomography (P = .2637; mean difference -0.3 μm; 95% LoA, -24.0 to 23.5 μm). The CCT by OCT correlated well with ultrasound and scanning-slit CCTs (r = 0.940 and r = 0.934, respectively). Conclusion: Pachymetric mapping with Fourier-domain OCT was highly repeatable. Repeatability was better with pupil-centered scans than with corneal vertex-centered scans. Ultrasound pachymetry, Fourier-domain OCT, and scanning-slit tomography should not be used interchangeably for CCT assessment. Financial Disclosure: No author has a financial or proprietary interest in any material or method mentioned. Additional disclosures are found in the footnotes.