Variability in fluorescein angiography interpretation for photodynamic therapy in age-related macular degeneration
Variability in fluorescein angiography interpretation for photodynamic therapy in age-related macular degeneration
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DOI：
10.1097/00006982-200212000-00001
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发表时间：
2002-12-01
影响因子：
3.3
通讯作者：
Margherio, RM
中科院分区：
文献类型：
--
作者：
Kaiser, RS;Berger, JW;Margherio, RM
目的：调查的变化，荧光素血管造影的解释光动力疗法在年龄相关性黄斑degeneration.Methods：八年级，其中包括两个TAP认证的眼科医生，其他三个视网膜专家，两名研究员在玻璃体视网膜疾病，和一个高级眼底照片分级，评估荧光素血管造影片的6例患者治疗根据治疗ARMD与维替泊芬（TAP）协议在一个单一的中心。评价每例患者的基线血管造影片，以确定CNV病变是否主要（大于或等于50%）为典型病变。在3、6、12和24个月的每次随访血管造影中，要求分级者确定是否存在荧光素渗漏。初始分级六个月后，再次向每位读片者展示每位患者的基线血管造影照片，并再次要求在不了解之前分级的情况下确定CNV病变是否以典型为主。所有分级均在不了解临床病程的情况下进行。结果：在分级首次访视和随访血管造影中，总体一致率分别为81%和82%。与两位TAP认证的眼科医生的分级相比，两组之间的一致率没有统计学差异。当对初次访视血管造影片进行重新分级时，观察者内变异性为17%。总体而言，分级与大多数人的意见不一致，约19%的decisions.Conclusions：相当大的变化，可以预期在荧光血管造影的解释作为TAP调查的结果应用于临床实践。
Objectives: To investigate the variability in fluorescein angiography interpretation for photodynamic therapy in age-related macular degeneration.Methods: Eight graders, who included two TAP-certified ophthalmologists, three other retinal specialists, two fellows in vitreoretinal diseases, and a senior fundus photograph grader, evaluated fluorescein angiograms of six patients treated according to the Treatment for ARMD With Verteporfin (TAP) protocol at a single center. Each patient's baseline angiogram was evaluated to determine whether the CNV lesion was predominantly (greater than or equal to50%) classic. For each follow-up angiogram, at 3,6,12, and 24 months, the grader was required to determine whether fluorescein leakage was present. Six months after the initial gradings, each reader was again presented with the baseline angiogram for each patient and once again asked to determine whether the CNV lesion was predominantly classic without knowledge of the previous grading. All gradings were performed without knowledge of the clinical course.Results: In grading initial visit and follow-up visit angiograms, the overall concordance rates were 81% and 82%, respectively. Concordance rates were not statistically different between the group as a whole when compared with the gradings of the two TAP-certified ophthalmologists. When initial visit angiograms were regraded, an intraobserver variability of 17% was noted. Overall, gradings were discordant with the majority opinion in approximately 19% of decisions.Conclusions: Considerable variability can be expected in fluorescein angiography interpretation as the results of the TAP investigation are applied to clinical practice.