Repeatability of OCT Lens Thickness Measures With Age and Accommodation

Purpose. To investigate crystalline lens thickness (LT) across a range of ages and accommodative demands and to evaluate the repeatability of LT measurements using the Visante Anterior Segment Optical Coherence Tomographer (AS-OCT) (Zeiss Meditec, Germany) under non-cycloplegic conditions. Methods. Participants were 98 visually normal adults aged 18-75 years, stratified into age groups of 18-29, 30-39, 40-49, 50-59, and 60-75 years of age. Images of the crystalline lens were taken using the Visante AS-OCT during stimulation of accommodation at demands of 0, 1, 2, 3, 4, 5, and 8 D with accommodative response measured in a subgroup of participants. Images were analyzed and LT measured assuming a refractive index of 1.42. Repeat measures were taken from 86 participants for each accommodative demand at a second visit. Results. The mean unaccommodated LT for all participants was 4.07 +/- 0.40 mm. An average increase in LT of 20 mu m per year was calculated (linear regression, R-2 = 0.61, F-(1,F-89) = 143.92, p < 0.00001). Increase in LT with accommodation was shown to be significant in the 18- to 29-year-olds (repeated measures ANOVA, F-(6,F-105) = 96.31, p < 0.00001), 30- to 39-year-olds (F-(6,F-93) = 71.25, p < 0.00001), and 40- to 49-year-olds (F-(6,F-90) = 12.60, p < 0.01) with little or no measureable change in the older age groups. Eighty-six participants returned for a second visit. The mean difference in LT in the unaccommodated state for all participants between visit 1 and visit 2 was 0.0006 mm (95% limits of agreement of -0.07 to 0.07 mm). The 95% limits of agreement were widest for youngest age groups and narrowest for the oldest participants. Conclusions. This study is the first to report the repeatability of LT measures using the Visante AS-OCT in the non-cyclopleged eye. It has also demonstrated the ability of the Visante AS-OCT to detect small changes in lens thickness with accommodation.