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Francis C. DeCroos, Cynthia A. Toth, Sandra Stinnett, Cynthia S. Heydary, Russell Burns, Glenn J. Jaffe, CATT Research Group; Reproducibility of Optical Coherence Tomography Image Grading During the Comparisons of Age-Related Macular Degeneration Treatments Trials (CATT). Invest. Ophthalmol. Vis. Sci. 2012;53(14):2895.
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To report Reading Center reproducibility during grading of Optical Coherence Tomography images obtained during the Comparisons of Age-Related Macular Degeneration Treatments Trials (CATT).
CATT readers performed standardized grading on OCT images. A reading team, composed of two independent readers and a Senior Reader, evaluated each scan. Grading included the CATT OCT endpoints of total thickness at the foveal center point and presence of intraretinal fluid (IRF), subretinal fluid (SRF), and sub-retinal pigment epithelium (RPE) fluid (sub-RPE fluid). Independent reading teams reevaluated 270 OCT scans randomly sampled from the first 2 years of CATT enrollment to determine reproducibility of qualitative grading and measurements. To assess temporal drift, a cohort of 23 scans submitted during the initial portion of the CATT study underwent repeated reproducibility analysis over the duration of the trial.
Reading Center teams reproducibly graded intraretinal fluid (percent agreement = 73%, kappa = 0.48, 95% CI 0.38 to 0.58), subretinal fluid (percent agreement = 90%, kappa = 0.80, 95% CI 0.73 to 0.87), and sub-RPE fluid (percent agreement 88%, kappa = 0.75, 95% CI 0.67 to 0.83). For independent Reading Center team measurements of total thickness at the foveal center point, the intraclass correlation was 0.99 (95% CI 0.99 to 0.99) and the absolute difference was 18.9 ± 17.9 micrometers. There was no qualitative or quantitative grading drift.
The standardized protocols used to evaluate OCT scans from the CATT study were reproducible. The methods used are suitable to monitor OCT imaging data from a large neovascular age related macular degeneration interventional multicenter study.
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