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Abstract #8400 Published in IGR 5-1
Reliability of the disc damage likelihood scale
Henderer JD; Liu C; Kesen M; Altangerel U; Bayer A; Steinmann WC; Spaeth GLAmerican Journal of Ophthalmology 2003; 135: 44-48
PURPOSE: To report the reliability of the glaucoma disc damage likelihood scale (DDLS) in comparison to the Armaly cup/disc ratio by determining the interobserver and intraobserver agreement for optic disc stereo photographs and the interobserver agreement for in vivo patient measurements of the optic disc. DESIGN: Observational case series. METHODS: Optic disc photographs: 48 stereo pairs of optic nerve photographs were selected from patients with a spectrum of glaucomatous visual field loss. Two masked observers graded the optic disc photographs three times according to the DDLS and Armaly cup/disc ratio. Interobserver and intraobserver agreements were calculated using the test-retest method. Patient measurements: three observers performed in vivo patient measurements on 34 eyes of glaucoma clinic patients and made a single determination of the DDLS stage and Armaly cup/disc ratio, based on the indirect biomicroscopic examination. Level of interobserver agreement was tabulated. RESULTS: Optic disc photographs: interobserver and intraobserver agreement for the vertical DDLS measurement was greater than for two determinations (clinical impression and measured) of the vertical Armaly cup/disc ratio (interobserver: 85 versus 68% and 74%, respectively; intraobserver grader 1: 97 versus 89% and 80%, grader 2: 99 versus 95% and 89%, respectively). In vivo patient measurements: the interobserver agreement for the DDLS and Armaly cup/disc ratio was similar (70.1 versus 67.6%, respectively). CONCLUSIONS: For the stereo optic disc photographs, the inter- and intra-observer agreement for the DDLS is greater than the Armaly cup/disc ratio. For the in vivo patient measurements, the level of agreement for the DDLS and the Armaly cup/disc ratio is similar.
Dr. J.D. Henderer, William and Anna Goldberg Glaucoma Service, Wills Eye Hospital, Thomas Jefferson University School of Medicine, Philadelphia, PA 19107, USA. henderer@willsglaucoma.org
Classification:
2.14 Optic disc (Part of: 2 Anatomical structures in glaucoma)
6.8.2 Posterior segment (Part of: 6 Clinical examination methods > 6.8 Photography)
