Interobserver agreement for the detection of optical coherence tomography features of neovascular age-related macular degeneration
Praveen J Patel 1*,
Andrew C Browning 1,
Fred K Chen 2,
Lyndon Da Cruz 2,
and
Adnan Tufail 1
1 Moorfields Eye Hospital, London, United Kingdom
2 Vitreoretinal Surgery, Moorfields Eye Hospital, London, United Kingdom
* To whom correspondence should be addressed. E-mail: praveenjpatel{at}yahoo.co.uk.
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Abstract |
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Purpose. To investigate the inter-observer agreement for the detection of optical coherence tomography (OCT) features of disease activity in patients with neovascular age-related macular degeneration (nAMD).
Method. A cross-sectional agreement study with grading of OCT line scans from patients with nAMD prior to receiving treatment conducted by 2 retinal specialists. Scans were graded for the presence of features of nAMD disease activity (intra-retinal cysts, IRC; subretinal fluid, SRF; diffuse retinal edema, DRE; retinal pigment epithelial detachment, PED and sub-retinal tissue, SRT).
Results. Though scans from 78 patients were available for analysis, 5 patients were excluded due to a mean signal strength of less than 7. Two hundred and seventy-eight line scans were analyzed from 73 patients (40 with cross-hair scan sets and 33 with radial line scan sets). Agreement for per line scan analysis was 77% for IRC (kappa = 0.41); 81% for SRF (kappa = 0.62); 91% for macular fluid (kappa = 0.28); 79% for DRE (kappa = 0.10); 90% for PED (kappa = 0.78); 79% for SRT (kappa = 0.53). There was 1 patient (with a cross-hair scan) in which the 2 observers disagreed regarding the presence of macular fluid.
Conclusion. Interpretation of OCT line scans from patients with nAMD is subject to inter-observer variability. However, when all line scans acquired are examined for the presence of fluid (IRC or SRF), there is a high level of agreement for the detection of macular fluid on a per patient basis.
Key Words:
optical coherence tomography, age-related macular degeneration, interobserver agreement
