Inter-observer agreement in grading severity of diabetic retinopathy in wide-field fundus photographs.


Journal

Eye (London, England)
ISSN: 1476-5454
Titre abrégé: Eye (Lond)
Pays: England
ID NLM: 8703986

Informations de publication

Date de publication:
04 2023
Historique:
received: 01 09 2021
accepted: 11 05 2022
revised: 22 04 2022
medline: 17 4 2023
pubmed: 21 5 2022
entrez: 20 5 2022
Statut: ppublish

Résumé

To examine the inter-observer agreement between two retina specialists in grading diabetic retinopathy (DR) severity in ultra-wide-field fundus photographs. Two hundred and seventy patients with diabetes, who visited the vitreoretinal specialty at a tertiary eye care hospital, with or without DR underwent comprehensive ophthalmic examination, dilated retinal exam and Optos ultra-wide-field (UWF) retinal photography. Optos images were graded for DR severity based on the International Clinical Diabetic Retinopathy Disease Severity Scale by two retina specialists with same number of years of experience, masked to the clinical details of the participants. The two graders showed agreement in 229/270 images (84.8%) and disagreement in 41/270 images (15.2%). The unweighted kappa for agreement between graders was k = 0.715, SE = 0.037 and the weighted kappa was k = 0.838, SE = 0.022. No DR was identified in 170/270 (62.9%) patients, mild NPDR in 15/270 (5.6%) patients, moderate NPDR in 35/270 (12.9%) patients, severe NPDR in 4/270 (1.48%) patient and PDR in 5/270 (1.85%) patients by both graders. Disagreement was neither related to the learning curve of graders nor with the patient's age (p = 0.574), gender (p = 0.169), duration of diabetes (0.660) or the lens being phakic or pseudophakic (p = 0.171) on logistic regression. The impact of disagreement noted between observers in grading DR on UWF fundus photographs should be considered when utilizing UWF system in clinical studies.

Identifiants

pubmed: 35595962
doi: 10.1038/s41433-022-02107-1
pii: 10.1038/s41433-022-02107-1
pmc: PMC10102141
mid: EMS144956
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1231-1235

Subventions

Organisme : Wellcome Trust
Pays : United Kingdom
Organisme : DBT-Wellcome Trust India Alliance
ID : IA/CPHE/16/1/502670
Pays : India
Organisme : Medical Research Council
ID : MR/P027881/1
Pays : United Kingdom

Informations de copyright

© 2022. The Author(s), under exclusive licence to The Royal College of Ophthalmologists.

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Auteurs

Sangeetha Srinivasan (S)

Vision Research Foundation, Chennai, India.

Shruthi Suresh (S)

Shri Bhagwan Mahavir Vitreoretinal services, Sankara Nethralaya, Chennai, India.

Charanya Chendilnathan (C)

Shri Bhagwan Mahavir Vitreoretinal services, Sankara Nethralaya, Chennai, India.

Jaya Prakash V (J)

Shri Bhagwan Mahavir Vitreoretinal services, Sankara Nethralaya, Chennai, India.

Sobha Sivaprasad (S)

NIHR Moorfields Biomedical Research Centre, London, UK.

Ramachandran Rajalakshmi (R)

Dr. Mohan's Diabetes Specialties Centre and Madras Diabetes Research Foundation, Chennai, India.

Ranjit Mohan Anjana (RM)

Dr. Mohan's Diabetes Specialties Centre and Madras Diabetes Research Foundation, Chennai, India.

Rayaz A Malik (RA)

Weill Cornell Medicine-Qatar, Education City, Doha, Qatar.
Institute of Cardiovascular Medicine, University of Manchester, Manchester, UK.

Vaitheeswaran Kulothungan (V)

National Centre for Disease Informatics and Research (NCDIR) & Indian Council of Medical Research (ICMR), Bangalore, India.

Rajiv Raman (R)

Shri Bhagwan Mahavir Vitreoretinal services, Sankara Nethralaya, Chennai, India.

Muna Bhende (M)

Shri Bhagwan Mahavir Vitreoretinal services, Sankara Nethralaya, Chennai, India. drmuna@snmail.org.

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