Evaluation of Optimized Digital Fundus Reflex Photographs for Lens Opacities in the Age-Related Eye Disease Study 2: AREDS2 Report 7
Identifieur interne : 001367 ( Pmc/Curation ); précédent : 001366; suivant : 001368Evaluation of Optimized Digital Fundus Reflex Photographs for Lens Opacities in the Age-Related Eye Disease Study 2: AREDS2 Report 7
Auteurs : Amitha Domalpally [États-Unis] ; Ronald P. Danis [États-Unis] ; Emily Y. Chew [États-Unis] ; Traci E. Clemons [États-Unis] ; Susan Reed [États-Unis] ; John Paul Sangiovanni [États-Unis] ; Frederick L. Ferris [États-Unis]Source :
- Investigative Ophthalmology & Visual Science [ 0146-0404 ] ; 2013.
Abstract
We described the system for grading lens opacities using stereoscopic digital fundus reflex photographs in the Age-Related Eye Disease Study 2 (AREDS2) and compared reproducibility with the AREDS lens grading system, which used retroillumination film images.
Stereoscopic fundus reflex photographs were acquired in a standardized fashion at baseline and annually. Images were enhanced and evaluated in the red channel at a central reading center. Percentage involvement of cortical and posterior subcapsular (PSC) lens opacities within the central 5 mm diameter zone of a modified AREDS lens grid was estimated. Reproducibility was assessed for contemporaneous variability (ongoing, monthly regrade on 5% of submissions,
In the contemporaneous exercise, the agreement for presence of cortical opacities was 93% (κ = 0.86) and for PSC opacities it was 97% (κ = 0.83). Intraclass correlation (ICC) for area of central zone involvement was 0.95 for cortical and 0.99 for PSC opacities. Historic data for contemporaneous regrading of film-based images in AREDS showed an ICC of 0.94 for cortical and 0.82 for PSC. The final annual temporal drift exercise had a reproducibility of 95% for cortical and PSC opacities.
Digital grading using fundus reflex images with image enhancing tools has reproducibility comparable to film-based retroillumination images, and may be useful for centralized objective lens opacity assessment in clinical trials using widely available fundus cameras. Red reflex images limit evaluation to cortical and PSC opacities, and do not permit assessment of nuclear opacities. (ClinicalTrials.gov number, NCT00345176.)
Url:
DOI: 10.1167/iovs.13-12301
PubMed: 23887802
PubMed Central: 3771555
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<author><name sortKey="Danis, Ronald P" sort="Danis, Ronald P" uniqKey="Danis R" first="Ronald P." last="Danis">Ronald P. Danis</name>
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<country xml:lang="fr">États-Unis</country>
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<author><name sortKey="Chew, Emily Y" sort="Chew, Emily Y" uniqKey="Chew E" first="Emily Y." last="Chew">Emily Y. Chew</name>
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<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">Maryland</region>
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<wicri:cityArea>National Institutes of Health, National Eye Institute, Bethesda</wicri:cityArea>
</affiliation>
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<author><name sortKey="Clemons, Traci E" sort="Clemons, Traci E" uniqKey="Clemons T" first="Traci E." last="Clemons">Traci E. Clemons</name>
<affiliation wicri:level="2"><nlm:aff id="aff3">EMMES Corporation, Rockville, Maryland</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">Maryland</region>
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<author><name sortKey="Reed, Susan" sort="Reed, Susan" uniqKey="Reed S" first="Susan" last="Reed">Susan Reed</name>
<affiliation wicri:level="2"><nlm:aff id="aff1">Fundus Photograph Reading Center, Department of Ophthalmology and Visual Science, Madison, Wisconsin</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">Wisconsin</region>
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</affiliation>
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<author><name sortKey="Sangiovanni, John Paul" sort="Sangiovanni, John Paul" uniqKey="Sangiovanni J" first="John Paul" last="Sangiovanni">John Paul Sangiovanni</name>
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<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">Maryland</region>
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<wicri:cityArea>National Institutes of Health, National Eye Institute, Bethesda</wicri:cityArea>
</affiliation>
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<author><name sortKey="Ferris, Frederick L" sort="Ferris, Frederick L" uniqKey="Ferris F" first="Frederick L." last="Ferris">Frederick L. Ferris</name>
<affiliation wicri:level="2"><nlm:aff id="aff2">National Institutes of Health, National Eye Institute, Bethesda, Maryland</nlm:aff>
<country xml:lang="fr">États-Unis</country>
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<wicri:cityArea>National Institutes of Health, National Eye Institute, Bethesda</wicri:cityArea>
</affiliation>
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<series><title level="j">Investigative Ophthalmology & Visual Science</title>
<idno type="ISSN">0146-0404</idno>
<idno type="eISSN">1552-5783</idno>
<imprint><date when="2013">2013</date>
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<front><div type="abstract" xml:lang="en"><sec id="st1"><title>Purpose.</title>
<p>We described the system for grading lens opacities using stereoscopic digital fundus reflex photographs in the Age-Related Eye Disease Study 2 (AREDS2) and compared reproducibility with the AREDS lens grading system, which used retroillumination film images.</p>
</sec>
<sec id="st2"><title>Methods.</title>
<p>Stereoscopic fundus reflex photographs were acquired in a standardized fashion at baseline and annually. Images were enhanced and evaluated in the red channel at a central reading center. Percentage involvement of cortical and posterior subcapsular (PSC) lens opacities within the central 5 mm diameter zone of a modified AREDS lens grid was estimated. Reproducibility was assessed for contemporaneous variability (ongoing, monthly regrade on 5% of submissions, <italic>n</italic>
= 777 eyes) and temporal drift (regrading a subset of baseline photographs annually, <italic>n</italic>
= 88).</p>
</sec>
<sec id="st3"><title>Results.</title>
<p>In the contemporaneous exercise, the agreement for presence of cortical opacities was 93% (κ = 0.86) and for PSC opacities it was 97% (κ = 0.83). Intraclass correlation (ICC) for area of central zone involvement was 0.95 for cortical and 0.99 for PSC opacities. Historic data for contemporaneous regrading of film-based images in AREDS showed an ICC of 0.94 for cortical and 0.82 for PSC. The final annual temporal drift exercise had a reproducibility of 95% for cortical and PSC opacities.</p>
</sec>
<sec id="st4"><title>Conclusions.</title>
<p>Digital grading using fundus reflex images with image enhancing tools has reproducibility comparable to film-based retroillumination images, and may be useful for centralized objective lens opacity assessment in clinical trials using widely available fundus cameras. Red reflex images limit evaluation to cortical and PSC opacities, and do not permit assessment of nuclear opacities. (ClinicalTrials.gov number, NCT00345176.)</p>
</sec>
</div>
</front>
</TEI>
<pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Invest Ophthalmol Vis Sci</journal-id>
<journal-id journal-id-type="iso-abbrev">Invest. Ophthalmol. Vis. Sci</journal-id>
<journal-id journal-id-type="hwp">iovs</journal-id>
<journal-id journal-id-type="pmc">iovs</journal-id>
<journal-id journal-id-type="publisher-id">IOVS</journal-id>
<journal-title-group><journal-title>Investigative Ophthalmology & Visual Science</journal-title>
</journal-title-group>
<issn pub-type="ppub">0146-0404</issn>
<issn pub-type="epub">1552-5783</issn>
<publisher><publisher-name>The Association for Research in Vision and Ophthalmology</publisher-name>
</publisher>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">23887802</article-id>
<article-id pub-id-type="pmc">3771555</article-id>
<article-id pub-id-type="doi">10.1167/iovs.13-12301</article-id>
<article-id pub-id-type="sici">iovs-54-08-32</article-id>
<article-id pub-id-type="other">IOVS-13-12301</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Clinical Trials</subject>
</subj-group>
</article-categories>
<title-group><article-title>Evaluation of Optimized Digital Fundus Reflex Photographs for Lens Opacities in the Age-Related Eye Disease Study 2: AREDS2 Report 7</article-title>
<alt-title alt-title-type="runhead">Optimized Digital Fundus Reflex Photographs</alt-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Domalpally</surname>
<given-names>Amitha</given-names>
</name>
<xref ref-type="aff" rid="aff1"><sup>1</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Danis</surname>
<given-names>Ronald P.</given-names>
</name>
<xref ref-type="aff" rid="aff1"><sup>1</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Chew</surname>
<given-names>Emily Y.</given-names>
</name>
<xref ref-type="aff" rid="aff2"><sup>2</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Clemons</surname>
<given-names>Traci E.</given-names>
</name>
<xref ref-type="aff" rid="aff3"><sup>3</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Reed</surname>
<given-names>Susan</given-names>
</name>
<xref ref-type="aff" rid="aff1"><sup>1</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>SanGiovanni</surname>
<given-names>John Paul</given-names>
</name>
<xref ref-type="aff" rid="aff2"><sup>2</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Ferris</surname>
<given-names>Frederick L.</given-names>
<suffix>III</suffix>
</name>
<xref ref-type="aff" rid="aff2"><sup>2</sup>
</xref>
</contrib>
<on-behalf-of>for the Age-Related Eye Disease Study 2 Research Group </on-behalf-of>
<xref rid="n103"><sup>4</sup>
</xref>
</contrib-group>
<aff id="aff1"><label>1</label>
Fundus Photograph Reading Center, Department of Ophthalmology and Visual Science, Madison, Wisconsin</aff>
<aff id="aff2"><label>2</label>
National Institutes of Health, National Eye Institute, Bethesda, Maryland</aff>
<aff id="aff3"><label>3</label>
EMMES Corporation, Rockville, Maryland</aff>
<author-notes><corresp id="cor1">Correspondence: Ronald P. Danis, Department of Ophthalmology and Visual Science, University of Wisconsin-Madison, 8010 Excelsior Drive, Madison, WI 53717; <email>rpdanis@wisc.edu</email>
.</corresp>
</author-notes>
<pub-date pub-type="epub"><day>5</day>
<month>9</month>
<year>2013</year>
</pub-date>
<pub-date pub-type="ppub"><month>9</month>
<year>2013</year>
</pub-date>
<volume>54</volume>
<issue>9</issue>
<fpage>5989</fpage>
<lpage>5994</lpage>
<history><date date-type="received"><day>26</day>
<month>4</month>
<year>2013</year>
</date>
<date date-type="accepted"><day>22</day>
<month>7</month>
<year>2013</year>
</date>
</history>
<permissions><copyright-statement>Copyright 2013 The Association for Research in Vision and Ophthalmology, Inc.</copyright-statement>
<copyright-year>2013</copyright-year>
</permissions>
<abstract><sec id="st1"><title>Purpose.</title>
<p>We described the system for grading lens opacities using stereoscopic digital fundus reflex photographs in the Age-Related Eye Disease Study 2 (AREDS2) and compared reproducibility with the AREDS lens grading system, which used retroillumination film images.</p>
</sec>
<sec id="st2"><title>Methods.</title>
<p>Stereoscopic fundus reflex photographs were acquired in a standardized fashion at baseline and annually. Images were enhanced and evaluated in the red channel at a central reading center. Percentage involvement of cortical and posterior subcapsular (PSC) lens opacities within the central 5 mm diameter zone of a modified AREDS lens grid was estimated. Reproducibility was assessed for contemporaneous variability (ongoing, monthly regrade on 5% of submissions, <italic>n</italic>
= 777 eyes) and temporal drift (regrading a subset of baseline photographs annually, <italic>n</italic>
= 88).</p>
</sec>
<sec id="st3"><title>Results.</title>
<p>In the contemporaneous exercise, the agreement for presence of cortical opacities was 93% (κ = 0.86) and for PSC opacities it was 97% (κ = 0.83). Intraclass correlation (ICC) for area of central zone involvement was 0.95 for cortical and 0.99 for PSC opacities. Historic data for contemporaneous regrading of film-based images in AREDS showed an ICC of 0.94 for cortical and 0.82 for PSC. The final annual temporal drift exercise had a reproducibility of 95% for cortical and PSC opacities.</p>
</sec>
<sec id="st4"><title>Conclusions.</title>
<p>Digital grading using fundus reflex images with image enhancing tools has reproducibility comparable to film-based retroillumination images, and may be useful for centralized objective lens opacity assessment in clinical trials using widely available fundus cameras. Red reflex images limit evaluation to cortical and PSC opacities, and do not permit assessment of nuclear opacities. (ClinicalTrials.gov number, NCT00345176.)</p>
</sec>
</abstract>
<abstract abstract-type="precis"><p>Fundus reflex images can be used to provide reproducible evaluation of cortical and posterior subcapsular opacities in large multicenter trials using widely available fundus cameras.</p>
</abstract>
<kwd-group><title>Keywords</title>
<kwd>cataract</kwd>
<kwd>lens opacity</kwd>
<kwd>AREDS2</kwd>
</kwd-group>
</article-meta>
</front>
</pmc>
</record>
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