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P. J. Patel, A. C. Browning, F. K. Chen, L. Da Cruz, A. Tufail; Interobserver Agreement in the Detection of Optical Coherence Tomography Features of Choroidal Neovascularization. Invest. Ophthalmol. Vis. Sci. 2009;50(13):5263.
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To determine the interobserver agreement in the detection of optical coherence tomography (OCT) features of choroidal neovascularization in patients with neovascular age-related macular degeneration (nAMD).
In this retrospective study, 2 retinal specialists certified as investigators for AMD clinical trials examined Stratus OCT line scans from 73 consecutive patients with neovascular AMD about to receive treatment. The scans were graded for the presence or absence of features of nAMD activity (intra-retinal cysts, IRC; subretinal fluid, SRF; diffuse retinal edema, DRE; pigment epithelial detachment, PED and sub-retinal tissue, SRT). Percentage and kappa agreement for each OCT feature were calculated.
A total of 278 individual line scans were analyzed for the 73 patient cohort (40 patients with crosshair scan sets and 33 with radial line scans). Agreement for per line scan analysis for IRC = 77% (kappa = 0.41); SRF = 81% (kappa = 0.60); fluid (IRC or SRF) = 90% (kappa = 0.26); PED = 90% (kappa = 0.78); SRT = 80% (kappa = 0.53%). When analyzing agreement on a per patient basis, both reviewers agreed on presence of macular fluid in at least 1 line scan from each scan set in 72 patients (99%). There was 1 patient (with a cross-hair scan) in which the 2 observers disagreed regarding the presence of macular fluid.
Interpretation of OCT line scans from patients with nAMD undergoing therapy is subject to inter-observer variability. However, in this cohort when all line scans acquired are examined for the presence of fluid (either IRC or SRF), there is a high level of agreement for the detection of macular fluid detection on a per patient basis.
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