Disagreement between anterior segment optical coherence tomography devices in eyes with a shallow anterior chamber

Purpose This study aimed to assess the level of agreement between anterior segment optical coherence tomography (AS-OCT) measurements obtained with the time-domain Visante® OCT and the swept-source DRI OCT Triton® in eyes with shallow anterior chambers under evaluation for angle closure, and was structured as an observational, cross-sectional design aimed at analyzing data obtained with two different types of anterior segment OCT devices. Methods Twenty-three patients were evaluated by gonioscopy before AS-OCT imaging. Anterior segment images were acquired under dark conditions using both Visante® and DRI OCT Triton®. The agreement of angle closure diagnosis between gonioscopy and AS-OCT was assessed with first-order agreement coefficients (AC1). Bland-Altman plots were used to assess the agreement of quantitative parameters obtained by both OCT devices. Results Significant differences were observed in all evaluated parameters. All angle-related measurements were higher with the DRI OCT Triton®, whereas all iris-related parameters were higher with the Visante®. Lens vault was significantly higher with the Visante® than with the DRI OCT Triton® (857.46 ± 279.38 µm vs. 310.68 ± 244.75 µm, p < 0.001). Anterior chamber width was significantly higher using DRI OCT Triton® than Visante® (11.91 ± 0.43mm vs. 11.42 ± 0.42 mm, p < 0.001). Agreement between devices ranged from good to excellent (ICC 0.61–0.90). Gonioscopy showed better agreement with the Visante® (AC1 = 0.52) than with the DRI OCT Triton® (AC1 = 0.12). Conclusion A substantial difference between parameters analyzed by AS-OCT devices was observed.