서로 다른 두 가지 스펙트랄 도메인 빛간섭단층촬영기를 이용한 눈물띠의 반복성과 재현성 비교
Repeatability and Reproducibility of Tear Meniscus Evaluations Using Two Different Spectral Domain-optical Coherence Tomography
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목적: 서로 다른 스펙트랄 도메인 빛간섭단층촬영기(optical coherence tomography, OCT)로 측정한 아래 눈물띠 측정치의 반복성, 재현성, 일치도를 알아보고자 하였다. 대상과 방법: 총 20명 20안을 Cirrus OCT와 Spectralis OCT를 이용하여 아래 눈물띠를 촬영하고, 2명의 검사자가 눈물띠의 너비와 높이를 각각 측정하였다. 이를 토대로 검사자 내 반복성, 검사자 간 재현성, 장치 간 일치도를 분석하였다. 결과: Cirrus OCT와 Spectralis OCT를 이용하여 측정한 눈물띠의 너비는 각각 검사자 1에서 151.25 ± 41.53 μm, 139.10 ± 40.56 μm, 검사자 2에서 152.03 ± 42.77 μm, 138.35 ± 39.70 μm였다. 높이는 검사자 1에서 291.90 ± 100.19 μm, 245.43 ± 66.44 μm, 검사자 2에서 288.25 ± 98.72 μm, 244.23 ± 60.69 μm로 측정되었다. 눈물띠 너비와 높이의 측정값은 검사자 내 및 검사자 간 유의한 차이가 관찰되지 않았다(모두 p>0.05). 검사자 내 반복성은 두 기기 모두 높은 신뢰도를 보였고(급내상관계수 ≥0.991) 검사자 간 변이계수는 2.04%에서 4.32%였다. 두 장치 간 95% 일치도 범위는 눈물띠의 너비는 -66.13 to 91.95 μm, 높이는 -127.18 to 217.68 μm였다. 결론: Cirrus OCT와 Spectralis OCT는 아래 눈물띠 측정에 유용하게 사용될 수 있다. 다만 두 기기 간 일치도는 좋지 못하므로 서로 대치하여 사용할 수는 없다.
Abstract
Purpose: To evaluate the repeatability and reproducibility of inferior tear meniscus measurements using two different spectral domain-optical coherence tomography (OCT), and to compare the inter-device agreements between these devices. Methods: Two examiners evaluated the tear meniscus depth (TMD) and tear meniscus height (TMH) of 20 eyes in 20 normal subjects using Cirrus OCT and Spectralis OCT with the examiners calculating the TMD and TMH. We analyzed intra-examiner repeatability, inter-examiner reproducibility, and inter-device agreement. Results: The average TMD measurements using the Cirrus OCT and Spectralis OCT devices were 151.25 ± 41.53 μm and 139.10 ± 40.56 μm by examiner 1, respectively, and 152.03 ± 42.77 μm and 138.35 ± 39.70 μm by examiner 2, respectively. The TMHs were 291.90 ± 100.19 μm and 245.43 ± 66.44 μm by examiner 1, respectively, and 288.25 ± 98.72 μm and 244.23 ± 60.69 μm by examiner 2, respectively. The TMDs and TMHs measured using these OCT devices were not statistically significant for intra- examiner and inter-examiner measurements (all, p > 0.05). These devices showed high repeatability (intraclass correlation coefficient ≥ 0.991) for intra-examiner TMD and TMH measurements and the inter-examiner coefficient of variation ranged from 2.04% to 4.32%. The 95% limits of agreement between the two devices were -66.13 to 91.95 μm for TMD and -127.18 to 217.68 μm for TMH. Conclusions: Both OCT devices are useful for conducting inferior tear meniscus measurements. The inter-device agreement was poor, and the devices were not interchangeable.
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