TY - JOUR
T1 - Monoscopic versus stereoscopic retinal photography for grading diabetic retinopathy severity
AU - Li, Helen K.
AU - Hubbard, Larry D.
AU - Danis, Ronald P.
AU - Esquivel, Adol
AU - Florez-Arango, Jose F.
AU - Krupinski, Elizabeth A.
PY - 2010/6
Y1 - 2010/6
N2 - Purpose. To assess agreement between monoscopic and stereoscopic photography for research classification of the severity of diabetic retinopathy (DR). Methods. Monoscopic digital (MD) images were compared with stereo digital (SD) and film (SF) photographs from a 152-eye cohort with full-spectrum Early Treatment Diabetic Retinopathy Study (ETDRS) severity levels for agreement on severity level, DR presence with ascending severity threshold, presence of DR index lesions, and repeatability of grading. Results. There was substantial agreement classifying ETDRS DR severity levels between MD and SF (k = 0.65, kw [linear weighted] = 0.87), MD and SD (k = 0.66, kw = 0.87), and SD and SF (k = 0.62, kw = 0.86) images. Marginal homogeneity analyses found no significant difference between MD and SF images (P = 0.53, Bhapkar test). The k agreement between MD and SF ranged from 0.80 to 0.94 for the presence or absence of eight ascending DR severity thresholds. Repeatability between the readers of the MD images was equal to or better than that of the readers of SD or SF images. Severity threshold grading repeatability between readers was similar with the MD and SF images. The k agreement between MD and SF for identifying diabetic retinopathy lesions ranged from moderate to almost perfect. The k comparisons showed that performance of grading new vessels on the disc in MD images was slightly lower than that with the SF images.
AB - Purpose. To assess agreement between monoscopic and stereoscopic photography for research classification of the severity of diabetic retinopathy (DR). Methods. Monoscopic digital (MD) images were compared with stereo digital (SD) and film (SF) photographs from a 152-eye cohort with full-spectrum Early Treatment Diabetic Retinopathy Study (ETDRS) severity levels for agreement on severity level, DR presence with ascending severity threshold, presence of DR index lesions, and repeatability of grading. Results. There was substantial agreement classifying ETDRS DR severity levels between MD and SF (k = 0.65, kw [linear weighted] = 0.87), MD and SD (k = 0.66, kw = 0.87), and SD and SF (k = 0.62, kw = 0.86) images. Marginal homogeneity analyses found no significant difference between MD and SF images (P = 0.53, Bhapkar test). The k agreement between MD and SF ranged from 0.80 to 0.94 for the presence or absence of eight ascending DR severity thresholds. Repeatability between the readers of the MD images was equal to or better than that of the readers of SD or SF images. Severity threshold grading repeatability between readers was similar with the MD and SF images. The k agreement between MD and SF for identifying diabetic retinopathy lesions ranged from moderate to almost perfect. The k comparisons showed that performance of grading new vessels on the disc in MD images was slightly lower than that with the SF images.
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U2 - 10.1167/iovs.09-4886
DO - 10.1167/iovs.09-4886
M3 - Article
C2 - 20053978
AN - SCOPUS:77953242072
SN - 0146-0404
VL - 51
SP - 3184
EP - 3192
JO - Investigative Ophthalmology and Visual Science
JF - Investigative Ophthalmology and Visual Science
IS - 6
ER -