Centre for Eye Research Australia, University of Melbourne, Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia.
Centre for Eye Research Australia, University of Melbourne, Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia.
Am J Ophthalmol. 2014 May;157(5):936-44. doi: 10.1016/j.ajo.2014.01.024. Epub 2014 Feb 4.
To determine whether monoscopic vs stereoscopic viewing impacts evaluation of optic disc photographs for glaucoma diagnosis in an expert population.
Prospective observational study.
Twenty pairs of high-quality monoscopic and stereoscopic photographs of similar size and magnification (ie, 40 images), were selected to demonstrate a range of optic disc features from a total of 197 eyes of 197 patients with glaucoma and normal subjects recruited from a tertiary clinic. These were presented in randomized order via an interactive platform (http://stereo.gone-project.com/). Participants assessed 9 topographic features and estimated glaucoma likelihood for each photograph. Main outcome measures were intra- and inter-observer agreement.
There was good intra-observer agreement between monoscopic and stereoscopic assessments of glaucoma likelihood (κw = 0.56). There was also good to substantial agreement for peripapillary atrophy (κw = 0.65), cup shape (κw = 0.65), retinal nerve fiber layer loss (κw = 0.69), vertical cup-to-disc ratio (κw = 0.58), and disc shape (κw = 0.57). However, intra-observer agreement was only fair to moderate for disc tilt, cup depth, and disc size (κw = 0.46-0.49). Inter-observer agreement for glaucoma likelihood in monoscopic photographs (κw = 0.61, 95% confidence interval [CI] = 0.55-0.67) was substantial and not lower than in stereoscopic photographs (κw = 0.59, CI = 0.54-0.65). Monoscopic photographs did not lead to lower levels of inter-observer agreement compared to stereoscopic photographs in the assessment of any optic disc characteristics, for example disc size (mono κw = 0.65, stereo κw = 0.52) and cup-to-disc ratio (mono κw = 0.72, stereo κw = 0.62).
For expert observers in the evaluation of optic disc photographs for glaucoma likelihood, monoscopic optic disc photographs did not appear to represent a significant disadvantage compared to stereoscopic photographs.
在专家人群中，确定单目与立体视图对视盘照片进行青光眼诊断评估是否存在影响。
前瞻性观察性研究。
从一家三级诊所招募的青光眼和正常受试者的 197 只眼中，选择了 20 对大小和放大倍数相似的高质量单目和立体照片（即 40 张图像），以展示一系列视盘特征。这些照片通过交互式平台（http://stereo.gone-project.com/）以随机顺序呈现。参与者评估了每张照片的 9 个地形特征，并估计了青光眼的可能性。主要观察指标是观察者内和观察者间的一致性。
单目和立体评估青光眼可能性的观察者内一致性良好（κw=0.56）。对于视盘周围萎缩（κw=0.65）、杯形（κw=0.65）、视网膜神经纤维层丢失（κw=0.69）、垂直杯盘比（κw=0.58）和盘形（κw=0.57），也有很好到实质性的一致性。然而，对于盘倾斜、杯深度和盘大小，观察者内一致性仅为中等至中等偏下（κw=0.46-0.49）。单目照片中青光眼可能性的观察者间一致性（κw=0.61，95%置信区间[CI]0.55-0.67）是实质性的，并不低于立体照片（κw=0.59，CI 0.54-0.65）。在评估任何视盘特征（例如盘大小[单目κw=0.65，立体κw=0.52]和杯盘比[单目κw=0.72，立体κw=0.62]）时，与立体照片相比，单目照片并没有导致观察者间一致性降低。
在评估青光眼可能性的视盘照片方面，对于专家观察者而言，与立体照片相比，单目视盘照片似乎并没有明显的劣势。
