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KMID : 1011420210260040307
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Journal of Korean Ophthalmic Optics Society
2021 Volume.26 No. 4 p.307 ~ p.214
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Assessment of Repeatability and Reproducibility of Non-Invasive TBUT Measurement Using the Bland-Altman Plot
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Jung Yee-Rin
Park Hyung-Min
Chu Byoung-Sun
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Abstract
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Purpose: This study aimed to assess the repeatability and reproducibility of non-invasive tear break-up time (NITBUT) between the Keratograph 5M and an autorefractor.
Methods: NITBUT was measured on the right eye of twenty-two participants (mean age=22.45±1.95 years, range: 20-27) by both the OCULUS Keratograph 5M and an autorefractor (Topcon KR-8100P). Intra-and inter-observer agreement was analyzed using the Bland-Altman plot.
Results: NITBUT was 8.04±1.30 sec and 7.24±1.20 sec (paired t-test, p=0.45) using an autorefractor and the Oculus Keratograph 5M, respectively. For inter-observer agreement, the upper limit of agreement (LOA) was 1.355 sec, the lower LOA was ?2.842 sec and the coefficient of repeatability (CoR) was 2.098 sec measured using an autorefractor. The upper LOA, lower LOA, and the CoR were 1.864 sec, ?1.208 sec, the and 1.536 sec, respectively, measured using the Keratograph 5M. For intra-observer agreement measured using an autorefractor, the upper LOA, lower LOA, and the CoR were 3.532 sec, ?1.410 sec, the and 2.471 sec, respectively. Conclusions: This study indicates that the Keratograph 5M provides better agreement than an autorefractor.
Considering that the Keratograph 5M analyses 22,000 points of image per frame, a mean difference of 1 sec, repeatability of 0.74 sec, and reproducibility of 1.06 sec by subjective observation from the examiner using an autorefractor may be considered useful for NITBUT measurements. However, each optometric practice uses a different device, and different examiners can cause errors in measurements; therefore, it is necessary to have a normal value.
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KEYWORD
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Tear Break-Up Time, Repeatability, Reproducibility, Non-invasive, Bland-Altman plot
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