Jessica I W Morgan1,2, Grace K Vergilio1, Jessica Hsu3, Alfredo Dubra4, Robert F Cooper1,5. 1. Scheie Eye Institute, Department of Ophthalmology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA. 2. Center for Advanced Retinal and Ocular Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA. 3. Department of Bioengineering, University of Pennsylvania, Philadelphia, PA, USA. 4. Department of Ophthalmology, Stanford University, Stanford, CA, USA. 5. Department of Psychology, University of Pennsylvania, Philadelphia, PA, USA.
Abstract
PURPOSE: Recent advances in adaptive optics scanning light ophthalmoscopy (AOSLO) have enabled visualization of cone inner segments through nonconfocal split-detection, in addition to rod and cone outer segments revealed by confocal reflectance. Here, we examined the interobserver reliability of cone density measurements in both AOSLO imaging modalities. METHODS: Five normal subjects (nine eyes) were imaged along the horizontal and vertical meridians using a custom AOSLO with confocal and nonconfocal split-detection modalities. The resulting images were montaged using a previously described semiautomatic algorithm. Regions of interest (ROIs) were selected from the confocal montage at 190 μm, and from split-detection and confocal montages at 900 and 1800 μm from the fovea. Four observers (three experts, one naïve) manually identified cone locations in each ROI, and these locations were used to calculate bound densities. Intraclass correlation coefficients and Dice's coefficients were calculated to assess interobserver agreement. RESULTS: Interobserver agreement was high in cone-only images (confocal 190 μm: 0.85; split-detection 900 μm: 0.91; split-detection 1800 μm: 0.89), moderate in confocal images at 900 μm (0.68), and poor in confocal images at 1800 μm (0.24). Excluding the naïve observer data substantially increased agreement within confocal images (190 μm: 0.99; 900 μm: 0.80; 1800 μm: 0.68). CONCLUSIONS: Interobserver measurements of cone density are more reliable in rod-free retinal images. Moreover, when using manual cell identification, it is essential that observers are trained, particularly for confocal AOSLO images. TRANSLATIONAL RELEVANCE: This study underscores the need for additional reliability studies in eyes containing pathology where identifying cones can be substantially more difficult.
PURPOSE: Recent advances in adaptive optics scanning light ophthalmoscopy (AOSLO) have enabled visualization of cone inner segments through nonconfocal split-detection, in addition to rod and cone outer segments revealed by confocal reflectance. Here, we examined the interobserver reliability of cone density measurements in both AOSLO imaging modalities. METHODS: Five normal subjects (nine eyes) were imaged along the horizontal and vertical meridians using a custom AOSLO with confocal and nonconfocal split-detection modalities. The resulting images were montaged using a previously described semiautomatic algorithm. Regions of interest (ROIs) were selected from the confocal montage at 190 μm, and from split-detection and confocal montages at 900 and 1800 μm from the fovea. Four observers (three experts, one naïve) manually identified cone locations in each ROI, and these locations were used to calculate bound densities. Intraclass correlation coefficients and Dice's coefficients were calculated to assess interobserver agreement. RESULTS: Interobserver agreement was high in cone-only images (confocal 190 μm: 0.85; split-detection 900 μm: 0.91; split-detection 1800 μm: 0.89), moderate in confocal images at 900 μm (0.68), and poor in confocal images at 1800 μm (0.24). Excluding the naïve observer data substantially increased agreement within confocal images (190 μm: 0.99; 900 μm: 0.80; 1800 μm: 0.68). CONCLUSIONS: Interobserver measurements of cone density are more reliable in rod-free retinal images. Moreover, when using manual cell identification, it is essential that observers are trained, particularly for confocal AOSLO images. TRANSLATIONAL RELEVANCE: This study underscores the need for additional reliability studies in eyes containing pathology where identifying cones can be substantially more difficult.
Authors: Min Chen; Robert F Cooper; Grace K Han; James Gee; David H Brainard; Jessica I W Morgan Journal: Biomed Opt Express Date: 2016-11-03 Impact factor: 3.732
Authors: Mortada A Abozaid; Christopher S Langlo; Adam M Dubis; Michel Michaelides; Sergey Tarima; Joseph Carroll Journal: Adv Exp Med Biol Date: 2016 Impact factor: 2.622
Authors: Jessica I W Morgan; Alfredo Dubra; Robert Wolfe; William H Merigan; David R Williams Journal: Invest Ophthalmol Vis Sci Date: 2008-10-24 Impact factor: 4.799
Authors: Alfredo Dubra; Yusufu Sulai; Jennifer L Norris; Robert F Cooper; Adam M Dubis; David R Williams; Joseph Carroll Journal: Biomed Opt Express Date: 2011-06-08 Impact factor: 3.732
Authors: Min Chen; Robert F Cooper; James C Gee; David H Brainard; Jessica I W Morgan Journal: Biomed Opt Express Date: 2019-11-25 Impact factor: 3.732
Authors: Niamh Wynne; Jenna A Cava; Mina Gaffney; Heather Heitkotter; Abigail Scheidt; Jenny L Reiniger; Jenna Grieshop; Kai Yang; Wolf M Harmening; Robert F Cooper; Joseph Carroll Journal: Biomed Opt Express Date: 2022-08-01 Impact factor: 3.562
Authors: Niamh Wynne; Heather Heitkotter; Erica N Woertz; Robert F Cooper; Joseph Carroll Journal: Transl Vis Sci Technol Date: 2022-05-02 Impact factor: 3.048
Authors: Michael J Ammar; Kurt T Scavelli; Katherine E Uyhazi; Emma C Bedoukian; Leona W Serrano; Ilaina D Edelstein; Grace Vergilio; Robert F Cooper; Jessica I W Morgan; Priyanka Kumar; Tomas S Aleman Journal: Retin Cases Brief Rep Date: 2021-11-01
Authors: Benjamin S Sajdak; Alexander E Salmon; Rachel E Linderman; Jenna A Cava; Heather Heitkotter; Joseph Carroll Journal: PLoS One Date: 2019-09-26 Impact factor: 3.240
Authors: Jessica I W Morgan; Min Chen; Andrew M Huang; Yu You Jiang; Robert F Cooper Journal: Transl Vis Sci Technol Date: 2020-07-16 Impact factor: 3.283