EVALUATION OF SEMIAUTOMATED MEASUREMENT OF GEOGRAPHIC ATROPHY IN AGE-RELATED MACULAR DEGENERATION BY FUNDUS AUTOFLUORESCENCE IN CLINICAL SETTING
EVALUATION OF SEMIAUTOMATED MEASUREMENT OF GEOGRAPHIC ATROPHY IN AGE-RELATED MACULAR DEGENERATION BY FUNDUS AUTOFLUORESCENCE IN CLINICAL SETTING
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DOI：
10.1097/01.iae.0000433986.32991.1e
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发表时间：
2014-03-01
影响因子：
3.3
通讯作者：
Souied, Eric H.
中科院分区：
文献类型：
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作者：
Panthier, Christophe;Querques, Giuseppe;Souied, Eric H.
目的：使用新型眼底自发荧光半自动软件对临床环境中的地图样萎缩进行定量，评估观察者内和观察者间不同临床经验医生之间的一致性。方法：29只眼睛（20名患者；平均年龄，79.6+/-6.2岁）的眼底自发荧光帧（激发：488 nm；发射：500-700 nm），患有继发于年龄相关性黄斑的地图样萎缩使用嵌入 Spectralis（海德堡工程公司，海德堡，德国）的半自动软件 Region Finder 来分析变性，并且没有脉络膜新生血管形成的迹象。对于每只研究眼睛，由 3 名具有不同程度临床经验的读者（2 名研究员和 1 名住院医师）独立执行两次半自动萎缩识别和量化（在 2 周的时间内）。评估观察者内和观察者间的一致性。结果：观察者内一致性的平均差异（Bland-Altman 统计）范围为 -0.17 mm(2) 至 0.13 mm(2)。在地理萎缩阈值为 15.72 mm(2) 之前，观察者内的一致性非常好。变异性与萎缩的大小相关。观察者间一致性的平均差异（Bland-Altman 统计）范围为 -0.25 mm(2) 至 0.27 mm(2)，高级读者和初级读者之间没有显着差异。多灶性病变或黄斑中心凹累及萎缩并不是产生分歧的原因。 结论：区域查找器是识别和量化年龄相关性黄斑变性患者地理萎缩的可靠工具，即使在临床环境中，即使由初级读者操作也是如此。
Purpose: To assess intraobserver and interobserver agreement among physicians with different degrees of clinical experience, using a novel fundus autofluorescence semiautomated software for quantification of geographic atrophy in clinical setting.Methods: Fundus autofluorescence frames (excitation: 488 nm; emission: 500-700 nm) of 29 eyes (20 patients; mean age, 79.6 +/- 6.2 years) with geographic atrophy secondary to age-related macular degeneration, and no signs of choroidal neovascularization, were analyzed using Region Finder, a semiautomated software embedded in Spectralis (Heidelberg Engineering, Heidelberg, Germany). For each study eye, semiautomated atrophy identification and quantification were independently performed, twice (in a 2-week time frame), by 3 readers with different degrees of clinical experience (2 fellows, and 1 resident). Intraobserver and interobserver agreements were assessed.Results: Mean difference in intraobserver agreement (Bland-Altman statistics) ranged from -0.17 mm(2) to 0.13 mm(2). Intraobserver agreement was excellent until the geographic atrophy threshold value of 15.72 mm(2). Variability correlated with the size of atrophy. Mean difference in interobserver agreement (Bland-Altman statistics) ranged from -0.25 mm(2) to 0.27 mm(2), with no significant difference between senior and junior readers. Multifocal lesion or foveal involvement in atrophy was not the cause of disagreement.Conclusion: Region Finder is a reliable tool for the identification and quantification of geographic atrophy in patients with age-related macular degeneration, in a clinical setting even when performed by junior reader.