Intra-observer repeatability and inter-observer agreement of the Smith method of measuring the anterior chamber depth

The Smith (1979) method provides a means of estimating the anterior chamber depth without additional attachments to the slit lamp [Smith, R. J. H. (1979). A new method of estimating the depth of the anterior chamber. Br. J. Ophthalmol. 63, 215-220]. In this study, the 95% intra-observer limits of repeatability and the 95% inter-observer limits of agreement of this method have been determined. The intra-observer limits of repeatability were determined by plotting the difference vs the mean of the estimated anterior chamber depth obtained in two different sessions by each of two examiners, while the inter-observer limits of agreement are represented by a plot of the difference vs the mean estimated anterior chamber depth between the two examiners. For one examiner, the 95% intra-observer limits of repeatability was -0.36 to 0.58 mm, while for the other examiner the 95% intra-observer limits of repeatability was -0.25 to 0.37 mm. The 95% inter-observer limits of agreement were -0.31 to 0.23 mm and -0.41 to 0.25 mm for the first and second sessions respectively. The intra-observer limits of repeatability are comparable with those reported for A-scan ultrasonographic measures of the anterior chamber depth. These results imply that the Smith method can be used with a high degree of repeatability and agreement to clinically monitor longitudinal changes in anterior chamber depth.