April 2010
Volume 51, Issue 13
Free
ARVO Annual Meeting Abstract  |   April 2010
Intra- and Interobserver Variability of Geographic Atrophy Quantification in Patients With AMD in a Reading Center Setting
P. Herrmann; S. Schmitz-Valckenberg; M. Fleckenstein; A. P. Goebel; F. G. Holz
Author Affiliations & Notes
  • P. Herrmann
    Department of Ophthalmology, University of Bonn, Bonn, Germany
  • S. Schmitz-Valckenberg
    Department of Ophthalmology, University of Bonn, Bonn, Germany
  • M. Fleckenstein
    Department of Ophthalmology, University of Bonn, Bonn, Germany
  • A. P. Goebel
    Department of Ophthalmology, University of Bonn, Bonn, Germany
  • F. G. Holz
    Department of Ophthalmology, University of Bonn, Bonn, Germany
  • Footnotes
    Commercial Relationships  P. Herrmann, Heidelberg Engineering, F; S. Schmitz-Valckenberg, Heidelberg Engineering, F; M. Fleckenstein, Heidelberg Engineering, F; A.P. Goebel, Heidelberg Engineering, F; F.G. Holz, Heidelberg Engineering, F; Acucela, C; Genentech, C; Novartis, C; Heidelberg Engineering, C; Carl Zeiss, C.
  • Footnotes
    Support  None.
Investigative Ophthalmology & Visual Science April 2010, Vol.51, 313. doi:
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      P. Herrmann, S. Schmitz-Valckenberg, M. Fleckenstein, A. P. Goebel, F. G. Holz; Intra- and Interobserver Variability of Geographic Atrophy Quantification in Patients With AMD in a Reading Center Setting. Invest. Ophthalmol. Vis. Sci. 2010;51(13):313.

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Abstract

Purpose: : Fundus autofluorescence (FAF) images can be used for semi-automated detection and measurements of areas of geographic atrophy (GA) due to age-related macular degeneration (AMD). The aim of this study was to determine intra- and interobserver reproducibility for the quantification of areas of GA in a reading center setting.

Methods: : Standardized FAF images were recorded with a confocal scanning laser ophthalmoscope (Spectralis/Heidelberg Retina Angiograph, Heidelberg Engineering, Germany). Two independent readers quantified total size of atrophy in 59 eyes with GA using semi-automated image analysis software. A total of 28 were analyzed a second time by each observer one month later in order to assess intraobserver variability. Minimum size for atrophic patches was set at 0.05 mm2. Corresponding infrared reflectance images were viewed side by side to FAF images for confirmation of GA lesion boundaries and foveal involvement. Agreement was assessed by Bland-Altman test.

Results: : The average GA area was 7.21 mm2. The first quartile was 2.56 mm2, the median 6.19 mm2 and the third quartile 10.69 mm2. The mean differences of intraobserver agreements were -0.06 mm2 (95% confidence interval [CI], -0.19 to 0.07) for reader 1 and -0.04 mm2 (95% CI, -0.15 to 0.08) for reader 2. Interobserver agreement showed a mean difference of 0.08 mm2 (95% CI, -0.07 to 0.22). Reasons for disagreement included difficulties in assessing foveal involvement, presence of confluent peripapillary atrophy and small GA satellites.

Conclusions: : Standardized semi-automated analysis of atrophy quantification using FAF images represents an accurate method with a high degree of reproducibility. Accurate measurements of GA areas plays a critical role for determining progression over time and, thus, for interventional clinical trials with therapies aiming at slowing enlargement of GA over time.

Keywords: age-related macular degeneration • imaging/image analysis: clinical • clinical (human) or epidemiologic studies: biostatistics/epidemiology methodology 
© 2010, The Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Permission to republish any abstract or part of an abstract in any form must be obtained in writing from the ARVO Office prior to publication.
Copyright © 2024 Association for Research in Vision and Ophthalmology.
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