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Interobserver agreement in detecting spectral-domain optical coherence tomography features of diabetic macular edema.

Heng LZ, Pefianaki M, Hykin P, Patel PJ - PLoS ONE (2015)

Bottom Line: Percentage concordance for SRF was 96% at all 3 regions analysed, whilst IRF was 96% at fovea and 98% at higher number of line-scans analysed.Concordance for MF was 100% at fovea and 98% at 1mm zone and whole scan with almost perfect and substantial κ respectively. κ agreement was substantial for VMT at all regions analysed.This finding is important as detection of macular fluid is used to guide retreatment with anti-angiogenic agents.

View Article: PubMed Central - PubMed

Affiliation: NIHR Moorfields Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, United Kingdom.

ABSTRACT

Purpose: To evaluate interobserver agreement for the detection of spectral-domain optical coherence tomography (SDOCT) features of diabetic macular edema (DME).

Method: Cross-sectional study in which 2 retinal specialists evaluated SDOCT scans from eyes receiving treatment for DME. Scans from 50 eyes with DME of 39 patients were graded for features of DME including intra-retinal fluid (IRF), diffuse retinal oedema (DRE), hyper-reflective foci (HRF), subretinal fluid (SRF), macular fluid and vitreomacular traction (VMT). Features were graded as present or absent at zones involving the fovea, 1mm from the fovea and the whole scan of 49 line scans. Analysis was performed using cross-tabulations for percentage concordance and kappa values (κ).

Results: In the 2950 line scans analysed, there was an increase in percentage concordance for DRE and HRF when moving from a foveal line scan, 1mm zone and then to a whole scan analysis (88% vs 94% vs 96%) and (88% vs 94% vs 94%) respectively with κ ranging from substantial to almost perfect. Percentage concordance for SRF was 96% at all 3 regions analysed, whilst IRF was 96% at fovea and 98% at higher number of line-scans analysed. Concordance for MF was 100% at fovea and 98% at 1mm zone and whole scan with almost perfect and substantial κ respectively. κ agreement was substantial for VMT at all regions analysed.

Conclusion: We report a high level of interobserver agreement in the detection of SDOCT features of DME. This finding is important as detection of macular fluid is used to guide retreatment with anti-angiogenic agents.

No MeSH data available.


Related in: MedlinePlus

(a-d) Optical coherence tomography images which demonstrate the disparity of assessments between the 2 graders.(a) foveal line scan, with disagreement on presence of Subretinal Fluid (SRF). (b-c) scans from 1mm zone which demonstrates disagreement on presence or absence of Diffuse Retinal Edema (DRE). Both graders agreed Macular Fluid [1] was present. (d) fovea line scan which graders disagreed on presence or absence of Macular Fluid.
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pone.0126557.g002: (a-d) Optical coherence tomography images which demonstrate the disparity of assessments between the 2 graders.(a) foveal line scan, with disagreement on presence of Subretinal Fluid (SRF). (b-c) scans from 1mm zone which demonstrates disagreement on presence or absence of Diffuse Retinal Edema (DRE). Both graders agreed Macular Fluid [1] was present. (d) fovea line scan which graders disagreed on presence or absence of Macular Fluid.

Mentions: Analysis was carried out for the foveal line scan (defined as the scan with the deepest depression in the centre of the scan, or otherwise scan number 25, the middle scan, if depression not present) and for a central 1 mm zone defined by 4 line scans above and 4 line scans below the foveal line scan) and for the whole volume scan (all 49 line scans included in the analysis). In all, 59 scans were analysed per patient and a total of 2950 line scans were analysed this series. Fig 2D demonstrates an example of a single foveal line scan with the deepest depression in the centre of the scan. Scans were analysed by viewing images on a standard computer monitor display using Heidelberg Explorer software version 5.7.4 with Spectralis OCT images database with no further image processing.


Interobserver agreement in detecting spectral-domain optical coherence tomography features of diabetic macular edema.

Heng LZ, Pefianaki M, Hykin P, Patel PJ - PLoS ONE (2015)

(a-d) Optical coherence tomography images which demonstrate the disparity of assessments between the 2 graders.(a) foveal line scan, with disagreement on presence of Subretinal Fluid (SRF). (b-c) scans from 1mm zone which demonstrates disagreement on presence or absence of Diffuse Retinal Edema (DRE). Both graders agreed Macular Fluid [1] was present. (d) fovea line scan which graders disagreed on presence or absence of Macular Fluid.
© Copyright Policy
Related In: Results  -  Collection

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getmorefigures.php?uid=PMC4440774&req=5

pone.0126557.g002: (a-d) Optical coherence tomography images which demonstrate the disparity of assessments between the 2 graders.(a) foveal line scan, with disagreement on presence of Subretinal Fluid (SRF). (b-c) scans from 1mm zone which demonstrates disagreement on presence or absence of Diffuse Retinal Edema (DRE). Both graders agreed Macular Fluid [1] was present. (d) fovea line scan which graders disagreed on presence or absence of Macular Fluid.
Mentions: Analysis was carried out for the foveal line scan (defined as the scan with the deepest depression in the centre of the scan, or otherwise scan number 25, the middle scan, if depression not present) and for a central 1 mm zone defined by 4 line scans above and 4 line scans below the foveal line scan) and for the whole volume scan (all 49 line scans included in the analysis). In all, 59 scans were analysed per patient and a total of 2950 line scans were analysed this series. Fig 2D demonstrates an example of a single foveal line scan with the deepest depression in the centre of the scan. Scans were analysed by viewing images on a standard computer monitor display using Heidelberg Explorer software version 5.7.4 with Spectralis OCT images database with no further image processing.

Bottom Line: Percentage concordance for SRF was 96% at all 3 regions analysed, whilst IRF was 96% at fovea and 98% at higher number of line-scans analysed.Concordance for MF was 100% at fovea and 98% at 1mm zone and whole scan with almost perfect and substantial κ respectively. κ agreement was substantial for VMT at all regions analysed.This finding is important as detection of macular fluid is used to guide retreatment with anti-angiogenic agents.

View Article: PubMed Central - PubMed

Affiliation: NIHR Moorfields Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, United Kingdom.

ABSTRACT

Purpose: To evaluate interobserver agreement for the detection of spectral-domain optical coherence tomography (SDOCT) features of diabetic macular edema (DME).

Method: Cross-sectional study in which 2 retinal specialists evaluated SDOCT scans from eyes receiving treatment for DME. Scans from 50 eyes with DME of 39 patients were graded for features of DME including intra-retinal fluid (IRF), diffuse retinal oedema (DRE), hyper-reflective foci (HRF), subretinal fluid (SRF), macular fluid and vitreomacular traction (VMT). Features were graded as present or absent at zones involving the fovea, 1mm from the fovea and the whole scan of 49 line scans. Analysis was performed using cross-tabulations for percentage concordance and kappa values (κ).

Results: In the 2950 line scans analysed, there was an increase in percentage concordance for DRE and HRF when moving from a foveal line scan, 1mm zone and then to a whole scan analysis (88% vs 94% vs 96%) and (88% vs 94% vs 94%) respectively with κ ranging from substantial to almost perfect. Percentage concordance for SRF was 96% at all 3 regions analysed, whilst IRF was 96% at fovea and 98% at higher number of line-scans analysed. Concordance for MF was 100% at fovea and 98% at 1mm zone and whole scan with almost perfect and substantial κ respectively. κ agreement was substantial for VMT at all regions analysed.

Conclusion: We report a high level of interobserver agreement in the detection of SDOCT features of DME. This finding is important as detection of macular fluid is used to guide retreatment with anti-angiogenic agents.

No MeSH data available.


Related in: MedlinePlus