Interobserver variability in confocal optic nerve analysis (HRT) View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2005-10

AUTHORS

Manuel M. Hermann, David F. Garway-Heath, Christian P. Jonescu-Cuypers, Reinhard O. W. Burk, Jost B. Jonas, Christian Y. Mardin, Jens Funk, Michael Diestelhorst

ABSTRACT

BACKGROUND/AIMS: To study the observer-related variability of optic nerve head (ONH) measurements using confocal laser scanning tomography (HRT I) in a screening setting. METHODS: Six experienced glaucoma specialists independently evaluated 50 ONH topographies from 25 adults using HRT software ver. 2.01 in a masked fashion. ONH topographies were obtained from a cohort study of 882 healthy adults and additionally included one patient with glaucomatous eyes. A glaucoma-screening-like setting was intended. The mean interobserver difference was defined as the mean percentual difference between an observer's analysis and the mean of all six observers for all eyes and all observers. The interobserver range was calculated for each eye as the percentual difference between the lowest and highest measurement, with the highest measurement as denominator. Additionally, Kendall's coefficient of rank concordance was assessed for the main HRT parameters. RESULTS: Mean disc area ranged from 1.83 +/- 0.49 to 2.21 +/- 0.40 mm(2) (mean interobserver difference: 8.3%; interobserver range: 5-50%; rank concordance: 0.86). The lowest mean interobserver differences were found for mean retinal nerve fibre layer thickness (RNFLT; 6.5%), maximum cup depth (2.9%) and cup shape (6.8%). An increased interobserver range was significantly correlated to a low cup to disc area ratio (r=0.64, P<0.0001). CONCLUSIONS: The observer-dependent diagnostic variability of HRT measurements can lead to divergent diagnostic evaluation of the ONH in a screening setting. Any HRT software relying on a reference database is exposed to relevant observer-related variability of the disc area. For screening purposes, HRT measurements should be completed by other diagnostic methods to compensate for possible diagnostic uncertainty. More... »

PAGES

143-149

References to SciGraph publications

  • 2001-09. Variability of the Normalised Rim/Disc area Quotient Estimated by Laser Scanning Tomography. A Comparison with Conventional Planimetry in INTERNATIONAL OPHTHALMOLOGY
  • 1996-04. The cumulative normalised rim/disc area ratio curve in GRAEFE'S ARCHIVE FOR CLINICAL AND EXPERIMENTAL OPHTHALMOLOGY
  • 2001-07. Evaluation and definition of physiologic macro cups with confocal optic nerve analysis (HRT) in INTERNATIONAL OPHTHALMOLOGY
  • 2000-05. Development of the standard reference plane for the Heidelberg retina tomograph in GRAEFE'S ARCHIVE FOR CLINICAL AND EXPERIMENTAL OPHTHALMOLOGY
  • 1999-02. Long-term fluctuations of the normalised rim/disc area ratio quotient in normal eyes in GRAEFE'S ARCHIVE FOR CLINICAL AND EXPERIMENTAL OPHTHALMOLOGY
  • Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1007/s10792-006-9022-9

    DOI

    http://dx.doi.org/10.1007/s10792-006-9022-9

    DIMENSIONS

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    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/17279310


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    40 schema:description BACKGROUND/AIMS: To study the observer-related variability of optic nerve head (ONH) measurements using confocal laser scanning tomography (HRT I) in a screening setting. METHODS: Six experienced glaucoma specialists independently evaluated 50 ONH topographies from 25 adults using HRT software ver. 2.01 in a masked fashion. ONH topographies were obtained from a cohort study of 882 healthy adults and additionally included one patient with glaucomatous eyes. A glaucoma-screening-like setting was intended. The mean interobserver difference was defined as the mean percentual difference between an observer's analysis and the mean of all six observers for all eyes and all observers. The interobserver range was calculated for each eye as the percentual difference between the lowest and highest measurement, with the highest measurement as denominator. Additionally, Kendall's coefficient of rank concordance was assessed for the main HRT parameters. RESULTS: Mean disc area ranged from 1.83 +/- 0.49 to 2.21 +/- 0.40 mm(2) (mean interobserver difference: 8.3%; interobserver range: 5-50%; rank concordance: 0.86). The lowest mean interobserver differences were found for mean retinal nerve fibre layer thickness (RNFLT; 6.5%), maximum cup depth (2.9%) and cup shape (6.8%). An increased interobserver range was significantly correlated to a low cup to disc area ratio (r=0.64, P<0.0001). CONCLUSIONS: The observer-dependent diagnostic variability of HRT measurements can lead to divergent diagnostic evaluation of the ONH in a screening setting. Any HRT software relying on a reference database is exposed to relevant observer-related variability of the disc area. For screening purposes, HRT measurements should be completed by other diagnostic methods to compensate for possible diagnostic uncertainty.
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