Reliability of a Manual Procedure for Marking the EZ Endpoint Location in Patients with Retinitis Pigmentosa.
Reliability of a Manual Procedure for Marking the EZ Endpoint Location in Patients with Retinitis Pigmentosa.
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DOI：
10.1167/tvst.5.3.6
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发表时间：
2016-05
影响因子：
3
通讯作者：
C Hood D
中科院分区：
文献类型：
--
作者：
Ramachandran R;X Cai C;Lee D;C Epstein B;Locke KG;G Birch D;C Hood D
我们开发并评估了一种训练程序，用于标记视网膜色素变性（RP）患者频域光学相干断层扫描（fdOCT）扫描的椭圆区（EZ）（也称为内段/外段（IS/OS）边界）的端点。编制了一份标记EZ终点的手册，并用于培训2名无经验的评分员。培训后，一名经验丰富的分级员和2名经过培训的分级员通过45名RP患者的黄斑标记fdOCT水平线扫描的终点。他们在1个月后再次标记这些相同扫描的终点。分级机内一致性极佳。组内相关系数（ICC）为0.99，终点位置（19.6 μm）的平均差异接近0 μm，95%限值在−284和323 μm之间，约为±1.1°。跨年级协议也是优秀的。ICC值为0.98（时间1）和0.97（时间2），分级员之间的平均差异接近于零，并且对于两个测试时间，这些差异的95%限值小于350 μm，约为1.2°。虽然自动算法越来越准确，但EZ端点仍然需要手动验证并在必要时进行纠正。通过培训，手动标记终点的分级者间和分级者内一致性非常好。对于临床研究，如果使用培训程序（包括手册），则可以手动标记EZ终点。终点置信区间远低于±2.0°，远小于通常使用的静态视野的6°间距。
We developed and evaluated a training procedure for marking the endpoints of the ellipsoid zone (EZ), also known as the inner segment/outer segment (IS/OS) border, on frequency domain optical coherence tomography (fdOCT) scans from patients with retinitis pigmentosa (RP). A manual for marking EZ endpoints was developed and used to train 2 inexperienced graders. After training, an experienced grader and the 2 trained graders marked the endpoints on fdOCT horizontal line scans through the macula from 45 patients with RP. They marked the endpoints on these same scans again 1 month later. Intragrader agreement was excellent. The intraclass correlation coefficient (ICC) was 0.99, the average difference of endpoint locations (19.6 μm) was close to 0 μm, and the 95% limits were between −284 and 323 μm, approximately ±1.1°. Intergrader agreement also was excellent. The ICC values were 0.98 (time 1) and 0.97 (time 2), the average difference among graders was close to zero, and the 95% limits of these differences was less than 350 μm, approximately 1.2°, for both test times. While automated algorithms are becoming increasingly accurate, EZ endpoints still have to be verified manually and corrected when necessary. With training, the inter- and intragrader agreement of manually marked endpoints is excellent. For clinical studies, the EZ endpoints can be marked by hand if a training procedure, including a manual, is used. The endpoint confidence intervals, well under ±2.0°, are considerably smaller than the 6° spacing for the typically used static visual field.