Interobserver agreement in the evaluation of acute retinal artery occlusion.

OBJECTIVE

To determine the agreement between two ophthalmologists in the evaluation of two important funduscopic features related to acute retinal artery occlusion: retinal cloudy swelling and visible retinal emboli.

DESIGN

An interobserver variability study in which two ophthalmologists (one trained in glaucoma, the other in neuro-ophthalmology) independently viewed fundus photographs and categorized them with respect to the presence or absence of cloudy swelling and retinal emboli. Inter- and intraobserver agreement was calculated with the kappa statistic.

SETTING

Retina service at a university-affiliated hospital in Kingston, Ont.

PATIENTS

The fundus photographs of 102 patients were included: 60 with acute retinal artery occlusion, 30 with conditions mimicking acute retinal artery occlusion and 12 healthy patients.

RESULTS

Both interobserver and intraobserver agreement as to the presence of retinal cloudy swelling were very high (kappa = 0.835 and 0.866 respectively). More variability was seen for the presence of retinal emboli, but, overall, interobserver and intraobserver agreement were still high (kappa = 0.726 and 0.629 respectively).

CONCLUSIONS

Our results suggest that clinicians use similar visual clues to categorize fundi with respect to retinal cloudy swelling and visible retinal emboli.