Inter-observer agreement for spectral- and time-domain optical coherence tomography image grading: a prospective study
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ORIGINAL PAPER
Inter-observer agreement for spectral- and time-domain optical coherence tomography image grading: a prospective study Pascal B. Knecht • Helena Kordic • Malaika Kurz-Levin • Veit Sturm • Marcel N. Menke
Received: 12 June 2012 / Accepted: 10 September 2012 / Published online: 22 September 2012 Ó Springer Science+Business Media B.V. 2012
Abstract The purpose of this study was to compare inter-observer agreement of StratusTM OCT versus SpectralisTM OCT image grading in patients with neovascular age-related macular degeneration (AMD). Thirty eyes with neovascular AMD were examined with StratusTM OCT and SpectralisTM OCT. Four different scan protocols were used for imaging. Three observers graded the images for the presence of various pathologies. Inter-observer agreement between OCT models was assessed by calculating intra-class correlation coefficients (ICC). In StratusTM OCT highest interobserver agreement was found for subretinal fluid (ICC: 0.79), and in SpectralisTM OCT for intraretinal cysts (IRC) (ICC: 0.93). SpectralisTM OCT showed superior interobserver agreement for IRC and epiretinal membranes (ERM) (ICCStratusTM: for IRC 0.61; for ERM 0.56; ICCSpectralisTM: for IRC 0.93; for ERM 0.84). Increased image resolution of SpectralisTM OCT did improve the inter-observer agreement for grading intraretinal cysts and epiretinal membranes but not for other retinal changes.
P. B. Knecht H. Kordic M. Kurz-Levin V. Sturm M. N. Menke Department of Ophthalmology, University Hospital Zurich, Zurich, Switzerland M. N. Menke (&) Department of Ophthalmology, University Hospital Bern, 3010 Bern, Switzerland e-mail: [email protected]
Keywords Age-related macular degeneration Image grading Optical coherence tomography Reproducibility Retina
Introduction Optical coherence tomography (OCT) was introduced in 1991 as a non-invasive, cross sectional imaging technique [1]. In 1995 Time-Domain OCT (TD-OCT) was used first for imaging macular diseases with many studies published about imaging in age-related macular degeneration (AMD) [2–15]. In neovascular AMD, retinal structure can be disturbed by choroidal neovascularisation (CNV) which is frequently associated with intraretinal cysts (IRC), subretinal fluid accumulation (SRF), pigment epithelium detachments (PED), and epiretinal membranes (ERM). In addition, one can frequently observe subretinal hyper-reflective material (SHM) in OCT images that might correspond to subretinal scar tissue, haemorrhages, fibrin formation and subretinal deposition or choroidal neovascularisations. Recently, different treatment modalities for neovascular AMD have been introduced [11, 12, 16–19]. Conventional TD-OCT plays an important role in following patients with neovascular AMD during therapy with intravitreal anti-VEGF agents such as ranibizumab or bevacizumab [16]. OCT imaging was part of main outcome measures in various clinical trials.
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This led to the creation of OCT reading centers where independent observers review OCT scans for defined pathologie
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