June 2017
Volume 58, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2017
A New Scale (Penn Scale) for Measuring Bulbar Conjunctival Redness from Digital Photographs
Author Affiliations & Notes
  • Ilaria Macchi
    Scheie Eye Institute, Philadelphia, Pennsylvania, United States
  • Vatinee Y Bunya
    Scheie Eye Institute, Philadelphia, Pennsylvania, United States
  • Mina Massaro-Giordano
    Scheie Eye Institute, Philadelphia, Pennsylvania, United States
  • Yuanjie Zheng
    School of Information Science and Engineering at Shandong Normal University, Jinan, China
  • Min Chen
    Radiology, University of Pennsylvania, Philadelphia, Pennsylvania, United States
  • Maureen G Maguire
    University di Pennsylvania, Philadelphia, Pennsylvania, United States
  • Richard A Stone
    University di Pennsylvania, Philadelphia, Pennsylvania, United States
  • Eli Smith
    University di Pennsylvania, Philadelphia, Pennsylvania, United States
  • Jim Gee
    University di Pennsylvania, Philadelphia, Pennsylvania, United States
  • Ebenezer Daniel
    University di Pennsylvania, Philadelphia, Pennsylvania, United States
  • Footnotes
    Commercial Relationships   Ilaria Macchi, None; Vatinee Bunya, Bausch & Lomb (F), NEI R01EY026972 (F), Shier (C); Mina Massaro-Giordano, The Eyelid Photography Protocol is copyright-protected by the University of Pennsylvania. (P); Yuanjie Zheng, Natural Science Foundation of China (NSFC) (61572300) (F), Natural Science Foundation of Shandong Province in China (ZR2014FM001) (F), Taishan Scholar Program of Shandong Province in China (TSHW201502038) (F); Min Chen, None; Maureen Maguire, The Eyelid Photography Protocol is copyright-protected by the University of Pennsylvania. (P); Richard Stone, The Eyelid Photography Protocol is copyright-protected by the University of Pennsylvania. (P); Eli Smith, None; Jim Gee, None; Ebenezer Daniel, The Eyelid Photography Protocol is copyright-protected by the University of Pennsylvania. (P)
  • Footnotes
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Investigative Ophthalmology & Visual Science June 2017, Vol.58, 665. doi:
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      Ilaria Macchi, Vatinee Y Bunya, Mina Massaro-Giordano, Yuanjie Zheng, Min Chen, Maureen G Maguire, Richard A Stone, Eli Smith, Jim Gee, Ebenezer Daniel; A New Scale (Penn Scale) for Measuring Bulbar Conjunctival Redness from Digital Photographs. Invest. Ophthalmol. Vis. Sci. 2017;58(8):665.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Current scales for measuring bulbar conjunctival redness have limitations when used with digital photographs. This study sought to develop a scale suited for digital images (Penn Scale) and compare the grading results from it to those using the VBR (Validated Bulbar Redness) scale.

Methods : A digital image database of 4889 color corrected nasal and temporal images of eyes with varying degrees of drug-induced bulbar conjunctival redness was reviewed to identify the least (score 1) and most severe redness (score 10), as well as 8 intermediate levels of redness. These 20 digital images, ten each of nasal and temporal, comprise the Penn scale, the linearity of which was assessed with an established image processing algorithm. 100 randomly selected images from the database were assessed by 3 professional non-physician graders using the Penn scale and the VBR scale. Agreement among graders was assessed with Kappa statistics using Cicchetti-Allison weights. The ease of use of the two scales was also documented.

Results : The Penn scale showed an almost perfect linearity of redness (Figure 1). The weighted Kappas for agreement between any two graders ranged from 0.57 to 0.73 for the Penn scale and from 0.38 to 0.66 for the VBR scale (Table 1). Among all three graders the weighted Kappa was 0.39 for the Penn scale and 0.14 for the VBR scale. In contrast to the VBR scale, the Penn scale allowed direct comparison of digital to digital images, could be used in a dimly lit environment conducive for evaluating digital images, had scaled bulbar conjunctival images for both temporal and nasal sides, and permitted reference scale images to be magnified to the same size as the images to be graded.

Conclusions : The Penn scale demonstrated several advantages over the VBR scale for the subjective measurement of bulbar redness from digital images.

This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.

 

 

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