Woetzel Anne K, Lauermann Jost L, Kreitz Kiana, Alnawaiseh Maged, Clemens Christoph R, Eter Nicole, Alten Florian
Department of Ophthalmology, University of Muenster Medical Center, Muenster, Germany.
Institute of Biostatistics and Clinical Research, University of Muenster, Muenster, Germany.
J Curr Ophthalmol. 2018 Dec 27;31(2):161-167. doi: 10.1016/j.joco.2018.12.002. eCollection 2019 Jun.
To compare optical coherence tomography angiography (OCT-A) image quality gradings performed by readers of varying retinal expertise levels in different retinal diseases.
Central 3 × 3 mm OCT-A images (AngioVue, Optovue) of 57 healthy controls (50.9 ± 22.4 years) and 148 patients (66.5 ± 14.1 years) affected by various chorioretinal diseases were retrospectively analyzed including early age-related macular degeneration (AMD, n = 26), neovascular AMD (nAMD, n = 22), and geographic atrophy due to AMD (GA, n = 6), glaucoma (n = 28), central serous chorioretinopathy (CSC, n = 14), epiretinal membrane (EM, n = 26), retinitis pigmentosa (RP, n = 16), and retinal venous occlusion (RVO, n = 10). A senior expert in medical retina (SE), an ophthalmology resident (OR), and a non-ophthalmologic medical doctor (MD) independently assessed OCT-A image quality using the motion artifact score (MAS) and the segmentation accuracy score (SAS).
Regarding MAS, inter-reader agreement between SE and OR was 93.7% (Cohen's kappa = 0.907) and 85.4% (Cohen's kappa = 0.786) between SE and MD. Regarding SAS, inter-reader agreement between SE and OR was 95.1% (Cohen's kappa = 0.92) and 92.2% (Cohen's kappa = 0.874) between SE and MD. In the SAS analysis, signal strength index (SSI) and presence of retinal pathology had a significant influence on the overall agreement ( = 0.046; < 0.001).
OCT-A image quality assessment can be performed most reliably by an ophthalmologist with knowledge in retinal image analysis. Yet, well-instructed non-ophthalmologic assessors show only slightly inferior results and, thus, may be integrated in routine OCT-A image quality assessment as well.
比较不同视网膜专业水平的阅片者对不同视网膜疾病的光学相干断层扫描血管造影（OCT-A）图像质量分级。
回顾性分析57名健康对照者（50.9±22.4岁）和148例受各种脉络膜视网膜疾病影响的患者（66.5±14.1岁）的中心3×3mm OCT-A图像（AngioVue，Optovue），这些疾病包括早期年龄相关性黄斑变性（AMD，n = 26）、新生血管性AMD（nAMD，n = 22）、AMD所致地图样萎缩（GA，n = 6）、青光眼（n = 28）、中心性浆液性脉络膜视网膜病变（CSC，n = 14）、视网膜前膜（EM，n = 26）、色素性视网膜炎（RP，n = 16）和视网膜静脉阻塞（RVO，n = 10）。一位视网膜医学高级专家（SE）、一名眼科住院医师（OR）和一名非眼科医生（MD）使用运动伪影评分（MAS）和分割准确性评分（SAS）独立评估OCT-A图像质量。
关于MAS，SE与OR之间的阅片者间一致性为93.7%（Cohen卡方 = 0.907），SE与MD之间为85.4%（Cohen卡方 = 0.786）。关于SAS，SE与OR之间的阅片者间一致性为95.1%（Cohen卡方 = 0.92），SE与MD之间为92.2%（Cohen卡方 = 0.874）。在SAS分析中，信号强度指数（SSI）和视网膜病变的存在对总体一致性有显著影响（ = 0.046； < 0.001）。
具有视网膜图像分析知识的眼科医生能最可靠地进行OCT-A图像质量评估。然而，经过良好指导的非眼科评估者结果仅略逊一筹，因此也可纳入常规OCT-A图像质量评估。
