International Photographic Classification and Grading System for Myopic Maculopathy
International Photographic Classification and Grading System for Myopic Maculopathy
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DOI：
10.1016/j.ajo.2015.01.022
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发表时间：
2015-05-01
影响因子：
4.2
通讯作者：
Wong, Tien Yin
中科院分区：
文献类型：
--
作者：
Ohno-Matsui, Kyoko;Kawasaki, Ryo;Wong, Tien Yin
目的：建立近视性黄斑病变的分类和分级系统。
设计：基于观察性病例系列，开发并评估近视性黄斑病变的分类系统。
方法：通过文献综述以及视网膜专家和临床科学家的共识会议，确定了一套全面的近视性黄斑病变。基于眼底照片以及改良的德尔菲法和共识，制定了近视性黄斑病变的分类。以一致性（%）和加权κ值评估观察者间和观察者内的可重复性。从日本东京医科齿科大学高度近视诊所的病例系列中选取了100张伴有近视和近视性黄斑病变的视网膜照片。
结果：我们将近视性黄斑病变分为5类，包括“无近视性视网膜退行性病变”（0类）、“豹纹状眼底”（1类）、“弥漫性脉络膜视网膜萎缩”（2类）、“片状脉络膜视网膜萎缩”（3类）和“黄斑萎缩”（4类）。另外定义了3种补充这些类别的特征作为“附加”病变，即漆裂纹、近视性脉络膜新生血管和富克斯斑。后巩膜葡萄肿被视为近视性视网膜病变的另一个重要体征。观察者内一致性≥85%，相应的加权κ统计量在观察之间≥0.6。经过简短的培训后，观察者间κ统计量达到预先定义的满意水平（≥0.4），被视为中度以上一致性。
结论：我们提出了一种可重复的近视性黄斑病变分类系统。在不同研究中应用统一的分类将有助于临床试验和流行病学研究结果的交流和比较。（C）2015年，爱思唯尔公司版权所有。
PURPOSE: To develop a classification and grading system for myopic maculopathy.DESIGN: Development and evaluation of a classification system for myopic maculopathy based on observational case series.METHODS: A comprehensive set of myopic macular lesions was defined via literature review and through consensus meetings among retinal specialists and clinician scientists. A classification of myopic maculopathy was formulated based on fundus photographs and a modified Delphi process and consensus. Inter- and intraobserver reproducibility, assessed as agreement (%) and weighted kappa values, were evaluated. One hundred retinal photographs with myopia and myopic macular lesions were selected from case series at the High Myopia Clinic of the Tokyo Medical and Dental University, Tokyo, Japan.RESULTS: We defined 5 categories of myopic maculopathy including "no myopic retinal degenerative lesion" (Category 0), "tessellated fundus" (Category 1), "diffuse chorioretinal atrophy" (Category 2), "patchy chorioretinal atrophy" (Category 3), and "macular atrophy" (Category 4). Three additional features to supplement these categories were defined as "plus" lesions, namely, lacquer cracks, myopic choroidal neovascularization, and Fuchs spot. Posterior staphyloma was considered as a further, important sign of myopic retinopathy. The intraobserver agreement was >= 85% and the corresponding weighted kappa statistic was >= 0.6 between observations. After a brief training session, interobserver kappa statistics reached the predefined satisfactory level (>= 0.4), considered as above moderate agreement.CONCLUSIONS: We propose a classification system for myopic maculopathy that was found to be reproducible. Applying a uniform classification in different studies will facilitate communication and comparison of findings from clinical trials and epidemiologic studies. (C) 2015 by Elsevier Inc. All rights reserved.