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Related Experiment Videos

Reliability of the disk damage likelihood scale.

Jeffrey D Henderer1, Connie Liu, Muge Kesen

  • 1William and Anna Goldberg Glaucoma Service, Wills Eye Hospital, Thomas Jefferson University School of Medicine, Philadelphia, Pennsylvania 19107, USA. henderer@willsglaucoma.org

American Journal of Ophthalmology
|December 31, 2002
PubMed
Summary

The glaucoma disk damage likelihood scale (DDLS) shows higher reliability than the Armaly cup/disk ratio for optic disk photographs. Agreement for both methods is similar in direct patient measurements.

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Area of Science:

  • Ophthalmology
  • Optometry
  • Medical Imaging

Background:

  • Glaucoma diagnosis relies on optic nerve assessment.
  • Quantifying optic nerve damage is crucial for glaucoma management.
  • The glaucoma disk damage likelihood scale (DDLS) and Armaly cup/disk ratio are used for this assessment.

Purpose of the Study:

  • To compare the reliability of the DDLS with the Armaly cup/disk ratio.
  • To determine interobserver and intraobserver agreement for both methods using optic disk stereo photographs.
  • To assess interobserver agreement for in vivo patient measurements of the optic disk.

Main Methods:

  • Observational case series design.
  • Two masked observers graded 48 optic disk stereo photographs three times using DDLS and Armaly cup/disk ratio.

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  • Three observers performed in vivo patient measurements on 34 glaucoma patients, determining DDLS stage and Armaly cup/disk ratio.

    • Main Results:

    • For optic disk photographs, interobserver agreement was 85% for DDLS versus 68% and 74% for Armaly cup/disk ratio.
    • Intraobserver agreement for DDLS was also higher (97-99%) compared to Armaly cup/disk ratio (80-95%).
    • For in vivo measurements, interobserver agreement was similar: 70.1% for DDLS and 67.6% for Armaly cup/disk ratio.

    Conclusions:

    • The DDLS demonstrates superior inter- and intra-observer agreement compared to the Armaly cup/disk ratio for stereo optic disk photographs.
    • Agreement levels for DDLS and Armaly cup/disk ratio are comparable in direct, in vivo patient measurements.