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Alfonso Anton-Lopez, Javier Moreno-Montanes, Vanesa Anton, Gema Rebolleda, Jose María Martínez de la Casa, Jose M Larrosa, Fernando Ussa, Maria Garcia-Granero; Intra and Inter-observer Agreement of Structural and Functional Glaucoma-Progression Software. Invest. Ophthalmol. Vis. Sci. 2016;57(12):347.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the intra-observer and inter-observer agreement of the visual field (VF) progression and OCT progression software among 5 experts in glaucoma from 5 different academic medical centers.
One-hundred clinical cases including only VF progression software (GPA from Humphrey) and OCT progression software (GPA from Cirrus-OCT) were randomized and subjectively and independently evaluated by 5 glaucoma subspecialists. Each set of cases was classified regarding progression as “none,” “questionable,” or “progression.” The experts also evaluated using both tests whether the glaucoma did actually progress and if they considered that change an indication for modifying the treatment. One month later, the same observers reevaluated the same sets but in different order to allow determination of intra-observer reproducibility. The level of agreement was estimated using Kappa statistics, and GWET's AC1 and 2.
The intra-observer agreement was moderate to substantial. The inter-observer agreement in VF progression and OCT progression software were moderate. No differences were found in inter-observer agreement between VF progression and OCT progression software. The inter-observer agreement was substantial in the “No progression” category, but fair in the “questionable” or “progression” categories. The inter-observer agreement of the questions about disease progression and the indication for treatment modification were fare to moderate. There were no changes in inter-observer agreement between the 1st and the 2nd evaluation.
Five glaucoma experts had substantial intra-observer agreement but only fair agreement in the glaucoma progression software both with structural and functional tests. According to these results the glaucoma progression software used in isolation is insufficient to obtain high inter-observer agreement in progression assessment among glaucoma experts.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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