Objective  To evaluate intra-session repeatability and reproducibility of optical quality parameters measured at objective and subjective best focuses in a double-pass system.
Methods  Thirty Chinese healthy adults (19 to 40-years old) meeting our inclusion criterion were enrolled in the study. After a basic eye examination, two methods of optical quality measurement, based on subjective and objective best focuses were performed using the Optical Quality Analysis System (OQAS) with an artificial pupil diameter of 4.0mm. With each method, three consecutive measurements of the following parameters: the modulation transfer function cutoff frequency (MTF_cutoff), the Strehl^2D ratio, the OQAS values (OVs) at contrasts of 100%, 20%, 9% and the objective scatter index (OSI) were performed by an experienced examiner. The repeatability of each method was evaluated by the repeatability limit (RL) and the coefficient of repeatability (COR). Reproducibility of the two methods was evaluated by intra-class correlation coefficient (ICC) and the 95% limits of agreement(Bland and Altman analysis).
Results  Thirty subjects, seven females and twenty three males, of whom 15 right eyes and 15 left eyes were selected randomly for recruitment in the study. The RLs (percentage) for the six parameters measured at objective focus and subjective focus ranged from 8.44% to 15.13% and 10.85% to 16.26%, respectively. The CORs for the two measurement methods ranged from 8.27% to 14.83% and 10.63% to 15.93%, respectively. With regard to reproducibility, the ICCs for the six parameters of OQAS ranged from 0.024 to 0.276. The 95% limits of agreement obtained for the six parameters (in comparison of the two methods) ranged from -0.57 to 42.18 (MTF_cutoff), -0.01 to 0.23 (Strehl^2D ratio), -0.02 to 1.40 (OV_100%), -0.10 to 1.75 (OV_20%), -0.14 to 1.80 (OV_9%) and -1.46 to 0.18 (OSI).
Conclusions  Measurements provided by OQAS with either method showed a good repeatability. However, the results obtained from the two different measurement methods showed a poor reproducibility. These findings suggest that it might be best to evaluate patients’ optical quality by OQAS using the best focus as chosen automatically by the instrument.