[SPA-2: semiology for phenotyping AMD: atrophic AMD].

Area of Science:

• Ophthalmology
• Medical Imaging
• Genetics

Context:

• Age-related macular degeneration (AMD) classification requires homogeneous subgroups for clinical and genetic studies.
• Current atrophic AMD classification lacks consensus and reproducibility.
• Advanced imaging techniques like OCT and angiography are used in AMD assessment.

Purpose:

• To evaluate a selected list of items for atrophic AMD classification using multiple imaging modalities.
• To assess the reproducibility and agreement of different items in classifying atrophic AMD.
• To propose modifications for a more discriminant and reproducible atrophic AMD classification grid.

Summary:

• Ten items for atrophy were assessed by five experienced readers and an expert using various imaging techniques for 20 eyes with atrophic AMD.
• The highest inter-observer agreement (Kappa=1) was for the presence of atrophy.
• The lowest inter-observer agreement was for the size of atrophy (Kappa=-0.0286±0.0769 to 0.1813±0.0835).

Impact:

• The study highlights the complexity and lack of consensus in current atrophic AMD classification.
• The proposed classification grid shows satisfactory inter-observer agreement for most items.
• Modifications are suggested to enhance the discriminant and reproducible nature of the atrophic AMD classification grid.