Abstract
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.
Original language | English |
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Journal | American Journal of Ophthalmology |
Volume | 150 |
Issue number | 5 |
DOIs | |
State | Published - Nov 1 2010 |
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ASJC Scopus subject areas
- Ophthalmology
Cite this
Scale for photographic grading of vitreous haze in Uveitis. / Davis, Janet L; Madow, Brian; Cornett, Jessica; Stratton, Rick; Hess, Ditte; Porciatti, Vittorio; Feuer, William J.
In: American Journal of Ophthalmology, Vol. 150, No. 5, 01.11.2010.Research output: Contribution to journal › Article
}
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
PY - 2010/11/1
Y1 - 2010/11/1
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.
UR - http://www.scopus.com/inward/record.url?scp=78049483575&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=78049483575&partnerID=8YFLogxK
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
JO - American Journal of Ophthalmology
JF - American Journal of Ophthalmology
SN - 0002-9394
IS - 5
ER -