Klein Ronald, Meuer Stacy M, Moss Scot E, Klein Barbara E K, Neider Michael W, Reinke Jennifer
Department of Ophthalmology and Visual Sciences, University of Wisconsin, Madison 53726, USA.
Arch Ophthalmol. 2004 Nov;122(11):1642-6. doi: 10.1001/archopht.122.11.1642.
To compare gradings of lesions associated with age-related macular degeneration (AMD) from digital and stereoscopic film images.
Instrument validation study.
Sixty-two subjects (124 eyes) with varying degrees of AMD, including no AMD.
Images of the optic disc and macula were taken using a 45 degrees digital camera (6.3 megapixels) through dark-adapted pupils and pharmacologically dilated pupils. In addition, 30 degrees stereoscopic retinal film images were taken through pharmacologically dilated pupils of the same eyes. All images were graded for drusen size, type, and area; pigmentary abnormalities; geographic atrophy; and neovascular lesions using the modified Wisconsin Age-Related Maculopathy Grading System. Exact agreement and unweighted kappa scores were calculated for paired gradings resulting from digital and film images.
Agreement between gradings obtained from stereoscopic slide transparencies and digital nonstereoscopic images.
Exact agreement between gradings of digital and stereoscopic film images taken through pharmacologically dilated pupils was 91% (kappa = 0.85) for the categories of none, early AMD, and late AMD. Exact agreement for gradings of digital images taken through dark-adapted pupils compared with gradings of film images was 80% (kappa = 0.69). Exact agreement for gradings of digital images captured through dark-adapted and pharmacologically dilated pupils was 86% (kappa = 0.78). In addition, kappa scores for agreement between different approaches for individual lesions were moderate to almost perfect.
Gradings resulting from high-resolution digital images, especially when the pupil is pharmacologically dilated, are comparable with those resulting from film-based images. We conclude that digital imaging of the retina is useful for epidemiological studies of AMD.
比较通过数字图像和立体胶片图像对年龄相关性黄斑变性（AMD）相关病变的分级。
仪器验证研究。
62名患有不同程度AMD（包括无AMD）的受试者（124只眼）。
使用45度数字相机（630万像素）通过暗适应瞳孔和药物散瞳拍摄视盘和黄斑图像。此外，通过对同一只眼睛药物散瞳拍摄30度立体视网膜胶片图像。使用改良的威斯康星年龄相关性黄斑病变分级系统对所有图像的玻璃膜疣大小、类型和面积、色素异常、地图样萎缩和新生血管病变进行分级。计算数字图像和胶片图像配对分级的精确一致性和未加权kappa评分。
立体幻灯片透明片和数字非立体图像分级之间的一致性。
通过药物散瞳拍摄的数字图像和立体胶片图像分级之间，在无AMD、早期AMD和晚期AMD类别中的精确一致性为91%（kappa = 0.85）。通过暗适应瞳孔拍摄的数字图像分级与胶片图像分级的精确一致性为80%（kappa = 0.69）。通过暗适应和药物散瞳拍摄的数字图像分级的精确一致性为86%（kappa = 0.78）。此外，不同方法对单个病变分级的一致性kappa评分从中度到几乎完美。
高分辨率数字图像的分级，尤其是在瞳孔药物散瞳时，与基于胶片的图像分级具有可比性。我们得出结论，视网膜数字成像对AMD的流行病学研究有用。
