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Intraobserver Repeatability Assessment of the S390L Firefly WDR Slitlamp in Patients With Dry Eye Disease

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Intraobserver Repeatability Assessment of the S390L Firefly WDR Slitlamp in Patients With Dry Eye Disease: Objective, Automated, and Noninvasive Measures


Ballesteros-Sánchez, Antonio O.D., M.Sc.; Gargallo-Martínez, Beatriz O.D., Ph.D.; Gutiérrez-Ortega, Ramón M.D., Ph.D.; Sánchez-González, José-María O.D., Ph.D.

Author Information
Eye & Contact Lens: Science & Clinical Practice 49(7):p 283-291, July 2023. | DOI: 10.1097/ICL.0000000000001001



Abstract

Objectives: 

To assess the intraobserver repeatability of automated, objective, and noninvasive measures obtained with the S390L Firefly WDR slitlamp.

Methods: 

This cross-sectional study included 50 eyes of patients with dry eye disease with a mean age of 55.06±12.96 years. Three consecutively repeated measures of the following variables were obtained: first noninvasive break-up time (F-NIBUT), average noninvasive break-up time (A-NIBUT), tear meniscus height, tear meniscus area (TMA), nasal ciliary hyperemia (NCIH), temporal ciliary hyperemia (TCIH), nasal conjunctival hyperemia (NCOH), temporal conjunctival hyperemia (TCOH), upper loss area meibomian gland (U-LAMG), lower loss area meibomian gland (L-LAMG), upper meibomian gland dysfunction grade (U-MGD grade), and lower meibomian gland dysfunction grade (L-MGD grade). Intraobserver repeatability was estimated with coefficient of variation (CoV), intrasubject standard deviation (SD) (Sw), and Bland–Altman plots.

Results: 

All variables showed no statistically significant differences in the repeated-measures analysis except for L-MGD grade (P=0.045). F-NIBUT and A-NIBUT obtained the highest CoV with an average value of 0.48±0.41 [0.02–1.00] and 0.34±0.25 [0.02–1.00], respectively. The remaining variables showed CoVs between 0.04±0.11 [0.00–0.43] and 0.18±0.16 [0.00–0.75]. A-NIBUT, TMA, NCOH, and L-LAMG obtained an Sw of 2.78s, 0.21 mm2, <0.001, and 4.11%, respectively. Bland–Altman plots showed a high level of agreement between pairs of repeated measures.

Conclusion: 

The S390L Firefly WDR slitlamp has moderate intraobserver repeatability for F-NIBUT and A-NIBUT, which suggests that F-NIBUT and A-NIBUT are tests with high variability. The remaining variables show satisfactory intraobserver repeatability.


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