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Y. Rutishauser–Arnold, H. AL–Rawi, C. Bunce, W. Xing, A.R. Webster, A.C. Bird, T. Peto; A comparison of stereoscopic fundus colour slides with digital non–stereoscopic fundus photographs for grading in Age–Related Maculopathy and Macular Degeneration . Invest. Ophthalmol. Vis. Sci. 2004;45(13):3070.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: The purpose of this study is to compare stereoscopic fundus colour slide transparencies and digital fundus imaging for grading in age–related maculopathy and macular degeneration. Methods: 102 eyes of 51 patients were randomly selected from a large ongoing collection of clinical data and DNA in a tertiary referral UK population. Retinal photography was performed with mydriasis using the Zeiss FF–series 30–degree fundus camera. Digital colour fundus photographs were taken at the same time with the Topcon TRC 501X camera. Each photograph was graded separately. There was a time–delay of at least two weeks between grading the colour fundus slides and the digital images. Grading was performed using a revised version of the grading system established by the International ARM Epidemiology Study. Exact agreement was calculated for all lesion categories. Results: Agreement for small hard drusen and intermediate soft drusen ranged between 29–80%, for drusen larger than 125 µm agreement ranged between 71–98%. For the presence of pigment abnormalities agreement ranged between 67–82% for hyperpigmentation and between 94–98% for hypopigmentation. For presence of geographic atrophy the concordance was 86–92% and for presence of neovascular AMD 86–92%. For features of neovascular AMD agreement ranged between 86–96%. Concordance for total area of geographic atrophy ranged between 84–88%. For total area of neovascularisation agreement was 74–78%. Agreement for predominant phenotype was 95%. There were five image pairs that contributed to most of the differences. These images had poor image quality either by overall quality or field definition. In three cases grading for hard drusen was difficult especially on digital imaging due to image quality. In the other two disagreements were due to lack of stereo on the digital picture. Conclusion: Overall digital imaging seems to be a useable technique in grading for ARM and AMD. It shows almost perfect agreement for predominant phenotype when compared with stereo film transparencies. However, in certain cases when judgment of subtle pathological changes are important the lack of stereo view in the digital imaging is a true disadvantage.
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