Zhichao Wu1, Maximilian Pfau2, Barbara A Blodi3, Frank G Holz4, Glenn J Jaffe5, Sandra Liakopoulos6, Srinivas R Sadda7, Giovanni Staurenghi8, Elvira Bjelopera6, Tyler Brown9, Petrus Chang4, John Choong5, Giulia Corradetti7, Federico Corvi7, Amitha Domalpally3, Cynthia Hurtenbach3, Muneeswar Gupta Nittala7, Anthony Olson9, Jeong W Pak3, Judith Pappe6, Marlene Saßmannshausen4, Cindy Skalak5, Sarah Thiele4, Robyn H Guymer1, Steffen Schmitz-Valckenberg10. 1. Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, Australia; Ophthalmology, Department of Surgery, The University of Melbourne, Melbourne, Australia. 2. GRADE Reading Center and Department of Ophthalmology, University of Bonn, Bonn, Germany; Ophthalmic Genetics and Visual Function Branch, National Eye Institute, National Institutes of Health, Bethesda, Maryland. 3. Fundus Photograph Reading Center, Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin. 4. GRADE Reading Center and Department of Ophthalmology, University of Bonn, Bonn, Germany. 5. DUKE Reading Center and Department of Ophthalmology, Duke University, Durham, North Carolina. 6. Cologne Image Reading Center and Laboratory and Department of Ophthalmology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany. 7. Doheny Imaging Reading Center and Doheny Eye Institute, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California. 8. Department of Biomedical and Clinical Science "Luigi Sacco," Luigi Sacco Hospital University of Milan, Milan, Italy. 9. Utah Retinal Reading Center, John A. Moran Eye Center, University of Utah, Salt Lake City, Utah. 10. GRADE Reading Center and Department of Ophthalmology, University of Bonn, Bonn, Germany; Utah Retinal Reading Center, John A. Moran Eye Center, University of Utah, Salt Lake City, Utah. Electronic address: steffen.valckenberg@utah.edu.
Abstract
PURPOSE: To determine the interreader agreement for incomplete retinal pigment epithelium (RPE) and outer retinal atrophy (iRORA) and complete RPE and outer retinal atrophy (cRORA) and their related features in age-related macular degeneration (AMD). DESIGN: Interreader agreement study. PARTICIPANTS: Twelve readers from 6 reading centers. METHODS: After formal training, readers qualitatively assessed 60 OCT B-scans from 60 eyes with AMD for 9 individual features associated with early atrophy and performed 7 different annotations to quantify the spatial extent of OCT features within regions of interest. The qualitative and quantitative features were used to derive the presence of iRORA and cRORA and also in an exploratory analysis to examine if agreement could be improved using different combinations of features to define OCT atrophy. MAIN OUTCOME MEASURES: Interreader agreement based on Gwet's first-order agreement coefficient (AC1) for qualitatively graded OCT features and classification of iRORA and cRORA, and smallest real difference (SRD) for quantitatively graded OCT features. RESULTS: Substantial or better interreader agreement was observed for all qualitatively graded OCT features associated with atrophy (AC1 = 0.63-0.87), except for RPE attenuation (AC1 = 0.46) and disruption (AC1 = 0.26). The lowest SRD for the quantitatively graded horizontal features was observed for the zone of choroidal hypertransmission (± 190.8 μm). Moderate agreement was found for a 3-category classification of no atrophy, iRORA, and cRORA (AC1 = 0.53). Exploratory analyses suggested a significantly higher level of agreement for a 3-category classification using (1) no atrophy; (2) presence of inner nuclear layer and outer plexiform layer subsidence, or a hyporeflective wedge-shaped band, as a less severe atrophic grade; and (3) the latter plus an additional requirement of choroidal hypertransmission of 250 μm or more for a more severe atrophic grade (AC1 = 0.68; P = 0.013). CONCLUSIONS: Assessment of iRORA and cRORA, and most of their associated features, can be performed relatively consistently and robustly. A refined combination of features to define early atrophy could further improve interreader agreement.
PURPOSE: To determine the interreader agreement for incomplete retinal pigment epithelium (RPE) and outer retinal atrophy (iRORA) and complete RPE and outer retinal atrophy (cRORA) and their related features in age-related macular degeneration (AMD). DESIGN: Interreader agreement study. PARTICIPANTS: Twelve readers from 6 reading centers. METHODS: After formal training, readers qualitatively assessed 60 OCT B-scans from 60 eyes with AMD for 9 individual features associated with early atrophy and performed 7 different annotations to quantify the spatial extent of OCT features within regions of interest. The qualitative and quantitative features were used to derive the presence of iRORA and cRORA and also in an exploratory analysis to examine if agreement could be improved using different combinations of features to define OCT atrophy. MAIN OUTCOME MEASURES: Interreader agreement based on Gwet's first-order agreement coefficient (AC1) for qualitatively graded OCT features and classification of iRORA and cRORA, and smallest real difference (SRD) for quantitatively graded OCT features. RESULTS: Substantial or better interreader agreement was observed for all qualitatively graded OCT features associated with atrophy (AC1 = 0.63-0.87), except for RPE attenuation (AC1 = 0.46) and disruption (AC1 = 0.26). The lowest SRD for the quantitatively graded horizontal features was observed for the zone of choroidal hypertransmission (± 190.8 μm). Moderate agreement was found for a 3-category classification of no atrophy, iRORA, and cRORA (AC1 = 0.53). Exploratory analyses suggested a significantly higher level of agreement for a 3-category classification using (1) no atrophy; (2) presence of inner nuclear layer and outer plexiform layer subsidence, or a hyporeflective wedge-shaped band, as a less severe atrophic grade; and (3) the latter plus an additional requirement of choroidal hypertransmission of 250 μm or more for a more severe atrophic grade (AC1 = 0.68; P = 0.013). CONCLUSIONS: Assessment of iRORA and cRORA, and most of their associated features, can be performed relatively consistently and robustly. A refined combination of features to define early atrophy could further improve interreader agreement.
Authors: Jeremy Liu; Rita Laiginhas; Federico Corvi; Frederick L Ferris; Tock Han Lim; Srinivas R Sadda; Nadia K Waheed; Prashanth G Iyer; Mengxi Shen; Yingying Shi; Omer Trivizki; Liang Wang; Elizabeth A Vanner; William J Feuer; Giovanni Gregori; Philip J Rosenfeld Journal: Ophthalmol Retina Date: 2022-01-31
Authors: Rait Parmann; Stephen H Tsang; Jana Zernant; Rando Allikmets; Vivienne C Greenstein; Janet R Sparrow Journal: Transl Vis Sci Technol Date: 2022-01-03 Impact factor: 3.283
Authors: Marlene Saßmannshausen; Sarah Thiele; Charlotte Behning; Maximilian Pfau; Matthias Schmid; Sérgio Leal; Ulrich F O Luhmann; Robert P Finger; Frank G Holz; Steffen Schmitz-Valckenberg Journal: Transl Vis Sci Technol Date: 2022-03-02 Impact factor: 3.283