Dataset Information

Accuracy of computer-assisted vertical cup-to-disk ratio grading for glaucoma screening.

ABSTRACT:

Purpose

Glaucoma screening can be performed by assessing the vertical-cup-to-disk ratio (VCDR) of the optic nerve head from fundus photography, but VCDR grading is inherently subjective. This study investigated whether computer software could improve the accuracy and repeatability of VCDR assessment.

Methods

In this cross-sectional diagnostic accuracy study, 5 ophthalmologists independently assessed the VCDR from a set of 200 optic disk images, with the median grade used as the reference standard for subsequent analyses. Eight non-ophthalmologists graded each image by two different methods: by visual inspection and with assistance from a custom-made publicly available software program. Agreement with the reference standard grade was assessed for each method by calculating the intraclass correlation coefficient (ICC), and the sensitivity and specificity determined relative to a median ophthalmologist grade of ?0.7.

Results

VCDR grades ranged from 0.1 to 0.9 for visual assessment and from 0.1 to 1.0 for software-assisted grading, with a median grade of 0.4 for each. Agreement between each of the 8 graders and the reference standard was higher for visual inspection (median ICC 0.65, interquartile range 0.57 to 0.82) than for software-assisted grading (median ICC 0.59, IQR 0.44 to 0.71); P = 0.02, Wilcoxon signed-rank test). Visual inspection and software assistance had similar sensitivity and specificity for detecting glaucomatous cupping.

Conclusion

The computer software used in this study did not improve the reproducibility or validity of VCDR grading from fundus photographs compared with simple visual inspection. More clinical experience was correlated with higher agreement with the ophthalmologist VCDR reference standard.

SUBMITTER: Snyder BM

PROVIDER: S-EPMC6687168 | biostudies-literature | 2019

REPOSITORIES: biostudies-literature

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Publications

Accuracy of computer-assisted vertical cup-to-disk ratio grading for glaucoma screening.

Snyder Blake M BM Nam Sang Min SM Khunsongkiet Preeyanuch P Ausayakhun Sakarin S Leeungurasatien Thidarat T Leiter Maxwell R MR Sevastopolsky Artem A Joye Ashlin S AS Berlinberg Elyse J EJ Liu Yingna Y Ramirez David A DA Moe Caitlin A CA Ausayakhun Somsanguan S Stamper Robert L RL Keenan Jeremy D JD

PloS one 20190808 8

<h4>Purpose</h4>Glaucoma screening can be performed by assessing the vertical-cup-to-disk ratio (VCDR) of the optic nerve head from fundus photography, but VCDR grading is inherently subjective. This study investigated whether computer software could improve the accuracy and repeatability of VCDR assessment.<h4>Methods</h4>In this cross-sectional diagnostic accuracy study, 5 ophthalmologists independently assessed the VCDR from a set of 200 optic disk images, with the median grade used as the re ...[more]

PMID: 31393904

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Dataset Information

Accuracy of computer-assisted vertical cup-to-disk ratio grading for glaucoma screening.

Purpose

Methods

Results

Conclusion

Publications

Accuracy of computer-assisted vertical cup-to-disk ratio grading for glaucoma screening.

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