TY - JOUR
T1 - Scale for photographic grading of vitreous haze in Uveitis
AU - Davis, Janet L.
AU - Madow, Brian
AU - Cornett, Jessica
AU - Stratton, Rick
AU - Hess, Ditte
AU - Porciatti, Vittorio
AU - Feuer, William J.
N1 - Funding Information:
Publication of this article was supported by an unrestricted departmental grant from Research to Prevent Blindness, Inc , New York, New York. Dr Davis has a consulting arrangement with Centocor and grant support from Centocor and Novartis . Dr Porciatti receives grant support from National Institutes of Health Center Grant P30-EY14801 , NIH R01EY019077 , NIH R01-EY014957 . Mr Feuer receives support from National Institutes of Health Center Grant P30-EY14801 . The study was supported by an unrestricted grant to the University of Miami from Research to Prevent Blindness, Inc . Involved in Design and conduct of the study (J.L.D., B.M., D.H., R.S., V.P.); Collection and management of data (J.L.D., B.M., J.C., D.H., R.S.); Analysis and interpretation of the data (J.L.D., B.M., W.J.F.); and Preparation and review (J.L.D., B.M., W.J.F.) and approval (J.L.D., B.M., J.C., R.S., D.H., V.P., W.J.F.) of the manuscript. The Human Subjects Research Committee at the University of Miami Miller School of Medicine approved conduct of the study and creation of a test set of photographs from patient files. Photography of the volunteer's eye was carried out with consent under a separate protocol. Grading of the test set in the simulated reading center environment was performed by Dr Brian Madow, Dr Ryan Rush, and Dr Namrata Kapoor.
PY - 2010/11
Y1 - 2010/11
N2 - Purpose: To validate a scale for grading vitreous haze in uveitis using digitized photographs and standardized scoring. Design: Evaluation of clinical research methodology. Methods: Calibrated Bangerter diffusion filters inducing incremental decrements of spatial contrast were placed in front of the camera lens while photographing a normal eye to simulate vitreous haze. The photographs were digitized and an ordinal scale was created from 0 (none) to 8 (highest level of opacification at which fundus details could be seen). The scale steps correspond approximately to decimal Snellen visual acuities of 1.0, 0.8, 0.4, 0.2, 0.1, 0.04, 0.02, 0.01, and 0.002, with approximately 0.3 log step between each step. For validation, digitized fundus photographs of uveitis patients were displayed on a computer monitor for comparison with the standard photos. Three observers graded the test set twice under standard conditions. Interobserver and intraobserver variability and κ values for agreement greater than chance were calculated. Results: Variance component analysis determined that 87.7% of the variance in grades was attributable to the test item rather than to grader or session. The intraclass correlation between graders and grading sessions varied from 0.84 to 0.91. Simple agreement within 1 grade between graders and sessions occurred in 90 ± 5.5% of gradings. κ values averaged 0.91, which is considered near perfect. Conclusions: A 9-step photographic scale was designed to standardize the grading of vitreous haze in uveitis patients using fundus photographs. The scale is potentially adaptable to clinical trials in uveitis.
AB - Purpose: To validate a scale for grading vitreous haze in uveitis using digitized photographs and standardized scoring. Design: Evaluation of clinical research methodology. Methods: Calibrated Bangerter diffusion filters inducing incremental decrements of spatial contrast were placed in front of the camera lens while photographing a normal eye to simulate vitreous haze. The photographs were digitized and an ordinal scale was created from 0 (none) to 8 (highest level of opacification at which fundus details could be seen). The scale steps correspond approximately to decimal Snellen visual acuities of 1.0, 0.8, 0.4, 0.2, 0.1, 0.04, 0.02, 0.01, and 0.002, with approximately 0.3 log step between each step. For validation, digitized fundus photographs of uveitis patients were displayed on a computer monitor for comparison with the standard photos. Three observers graded the test set twice under standard conditions. Interobserver and intraobserver variability and κ values for agreement greater than chance were calculated. Results: Variance component analysis determined that 87.7% of the variance in grades was attributable to the test item rather than to grader or session. The intraclass correlation between graders and grading sessions varied from 0.84 to 0.91. Simple agreement within 1 grade between graders and sessions occurred in 90 ± 5.5% of gradings. κ values averaged 0.91, which is considered near perfect. Conclusions: A 9-step photographic scale was designed to standardize the grading of vitreous haze in uveitis patients using fundus photographs. The scale is potentially adaptable to clinical trials in uveitis.
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U2 - 10.1016/j.ajo.2010.05.036
DO - 10.1016/j.ajo.2010.05.036
M3 - Article
C2 - 20719302
AN - SCOPUS:78049483575
VL - 150
SP - 637-641.e1
JO - American Journal of Ophthalmology
JF - American Journal of Ophthalmology
SN - 0002-9394
IS - 5
ER -