Author(s): Gangaputra SS, Altaweel MM, Peng Q, Friedman DS, Rao PK, Foster CS, Kim RY, Reed SB, Srivastava SK, Wong IG, Kempen JH; MUST Trial Research Group. Morphologic assessment for glaucoma in the Multicenter Uveitis Steroid Treatment (MUST) trial. Ocul Immunol Inflamm. 2011 Aug;19(4):267-74. doi: 10.3109/09273948.2011.583376. PMID 21770805
Journal: Ocular Immunology And Inflammation, Volume 19, Issue 4, Aug 2011
PURPOSE To compare Reading Center (RC) cup-to-disc ratio (CDR) assessment from stereoscopic photographs with clinician estimation in a uveitis clinical trial.
METHODS Clinical estimation of CDR was performed by ophthalmologists via dilated biomicroscopy. Photographic evaluation was performed at an independent RC by masked, certified evaluators. Quality control was performed by repeat grading of 77 randomly selected images.
RESULTS Among 479 eyes with uveitis, 353 eyes had clinical and photographic grades for CDR. Agreement between clinical and RC grading was fair, with exact agreement of 29%. Agreement within 0.1 and 0.2 CDR was 70 and 93%, respectively (weighted κ = .34). Intergrader reproducibility at the RC was better (weighted κ = .59, ICC 0.74).
CONCLUSION Morphologic assessment of cup to disc ratio is an important outcome and safety measure for determining glaucomatous damage in clinical trials. Masked RC measurements are more likely to be accurate than biomicroscopic grading in identifying meaningful anatomical change associated with glaucoma.