Agreement among ophthalmologists in evaluating fluorescein angiograms in patients with neovascular age-related macular degeneration for photodynamic therapy eligibility (FLAP-Study)
Agreement among ophthalmologists in evaluating fluorescein angiograms in patients with neovascular age-related macular degeneration for photodynamic therapy eligibility (FLAP-Study)
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DOI：
10.1016/s0161-6420(02)01770-0
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发表时间：
2003-02-01
期刊：
影响因子：
13.7
通讯作者：
Unnebrink, K
中科院分区：
文献类型：
--
作者：
Holz, FG;Jorzik, J;Unnebrink, K
目的：确定观察者内和观察者间差异，以对渗出性年龄相关性黄斑变性 (ARMD) 中的脉络膜新生血管 (CNV) 类型进行分类。设计：检查者内和检查者间可靠性研究。参与者：由 16 名视网膜专家独立评估 40 名新生血管性 ARMD 患者的数字化高质量荧光素血管造影照片。 结果测量：荧光素血管造影以两个随机序列（系列 A 和 B）呈现给每个蒙蔽阅读器，以将 CNV 类型分类为经典型、隐匿型或与经典成分混合（小于或大于 50%）。通过计算 kappa 统计量 (kappa) 和组内相关系数来评估一致性。结果：观察者内变异的平均 kappa 系数为 0.64 +/- 0.11，范围为 0.44 至 0.89。对于观察者间变异，A 系列的组内相关系数计算为 0.66（95% 置信区间 [Cl] 0.56, 0.77），B 系列的计算为 0.55（95% CI 0.43, 0.67）。结论：继发于 ARMD 的 CNV 的血管造影分类不仅在观察者之间存在很大差异，而且同一观察者的重复评估也会存在很大差异。由于包括光动力疗法在内的各种当前和新兴的治疗方法都是基于特定的血管造影特征，因此准确的解释将变得更加重要。眼科 2003；110:400-405 (C) 2003 年，美国眼科学会。
Objective: To determine intraobserver and interobserver variation for classifying types of choroidal neovascularizations (CNV) in exudative age-related macular degeneration (ARMD).Design: Intraexaminer and interexaminer reliability study.Participants: Digital high-quality fluorescein angiograms of 40 patients with neovascular ARMD were evaluated independently by 16 retinal specialists.Main Outcome Measures: Fluorescein angiographies were presented in two randomized sequences (series A and B) to each masked reader for classification of type of CNV into classic, occult, or mixed with classic component of less or greater 50%. Agreement was evaluated by calculating kappa statistics (kappa) and intraclass correlation coefficients.Results: The mean kappa coefficient was 0.64 +/- 0.11 for intraobserver variation, with a range from 0.44 to 0.89. For interobserver variation the intraclass correlation coefficients was calculated as 0.66 (95% confidence interval [Cl] 0.56, 0.77) for series A and as 0.55 (95% Cl 0.43, 0.67) for series B.Conclusions: Angiographic classification of CNV secondary to ARMD can vary considerably not only between observers but also for repeated evaluation by the same observer. Because various current and emerging treatments including photodynamic therapy are based on specific angiographic characteristics, accurate interpretation will become more important. Ophthalmology 2003;110:400-405 (C) 2003 by the American Academy of Ophthalmology.