Department of Ophthalmology and Visual Sciences, University of Texas Medical Branch, Galveston, Texas 77555-1106, USA.
Invest Ophthalmol Vis Sci. 2010 Jun;51(6):3184-92. doi: 10.1167/iovs.09-4886. Epub 2010 Jan 6.
To assess agreement between monoscopic and stereoscopic photography for research classification of the severity of diabetic retinopathy (DR).
Monoscopic digital (MD) images were compared with stereo digital (SD) and film (SF) photographs from a 152-eye cohort with full-spectrum Early Treatment Diabetic Retinopathy Study (ETDRS) severity levels for agreement on severity level, DR presence with ascending severity threshold, presence of DR index lesions, and repeatability of grading.
There was substantial agreement classifying ETDRS DR severity levels between MD and SF (kappa = 0.65, kappa(w) [linear weighted] = 0.87), MD and SD (kappa = 0.66, kappa(w) = 0.87), and SD and SF (kappa = 0.62, kappa(w) = 0.86) images. Marginal homogeneity analyses found no significant difference between MD and SF images (P = 0.53, Bhapkar test). The kappa agreement between MD and SF ranged from 0.80 to 0.94 for the presence or absence of eight ascending DR severity thresholds. Repeatability between the readers of the MD images was equal to or better than that of the readers of SD or SF images. Severity threshold grading repeatability between readers was similar with the MD and SF images. The kappa agreement between MD and SF for identifying diabetic retinopathy lesions ranged from moderate to almost perfect. The kappa comparisons showed that performance of grading new vessels on the disc in MD images was slightly lower than that with the SF images.
Monoscopic photography can equal the reliability of stereo photography for full ETDRS DR severity scale grading.
评估单眼和立体摄影在糖尿病视网膜病变（DR）严重程度的研究分类中的一致性。
将 152 只眼的全谱早期治疗糖尿病视网膜病变研究（ETDRS）严重程度的单眼数字（MD）图像与立体数字（SD）和胶片（SF）照片进行比较，以评估严重程度分级、DR 随严重程度递增阈值的存在、DR 指数病变的存在以及分级的重复性方面的一致性。
MD 和 SF（kappa=0.65，kappa(w)[线性加权]=0.87）、MD 和 SD（kappa=0.66，kappa(w)=0.87）以及 SD 和 SF（kappa=0.62，kappa(w)=0.86）图像之间对 ETDRS DR 严重程度分级具有高度一致性。边缘同质性分析发现 MD 和 SF 图像之间没有显著差异（P=0.53，Bhapkar 检验）。MD 和 SF 图像之间的kappa 一致性在 0.80 到 0.94 之间，用于确定八个递增 DR 严重程度阈值的存在或不存在。MD 图像的读者间重复性与 SD 或 SF 图像的读者间重复性相同或更好。读者间严重程度阈值分级的重复性与 MD 和 SF 图像相似。MD 和 SF 图像对识别糖尿病视网膜病变病变的kappa 一致性从中度到几乎完美。kappa 比较表明，MD 图像上视盘新生血管的分级性能略低于 SF 图像。
单眼摄影术在全 ETDRS DR 严重程度分级方面可以与立体摄影术具有同等的可靠性。
