Inter-observer agreement for spectral- and time-domain optical coherence tomography image grading: a prospective...

Area of Science:

• Ophthalmology
• Medical Imaging
• Retinal Diseases

Background:

• Neovascular age-related macular degeneration (AMD) is a leading cause of vision loss.
• Accurate imaging and grading are crucial for managing AMD.
• Optical Coherence Tomography (OCT) is a key imaging modality.

Purpose of the Study:

• To compare the inter-observer agreement of Stratus™ OCT and Spectralis™ OCT for grading neovascular AMD.
• To evaluate the impact of image resolution on grading accuracy.

Main Methods:

• Thirty eyes with neovascular AMD were imaged using both Stratus™ OCT and Spectralis™ OCT.
• Three observers graded images for various pathologies using four scan protocols.
• Inter-observer agreement was assessed using intra-class correlation coefficients (ICC).

Main Results:

• Spectralis™ OCT demonstrated superior inter-observer agreement for intraretinal cysts (IRC) (ICC: 0.93) and epiretinal membranes (ERM) (ICC: 0.84) compared to Stratus™ OCT (IRC ICC: 0.61; ERM ICC: 0.56).
• Stratus™ OCT showed highest agreement for subretinal fluid (ICC: 0.79).
• Higher image resolution of Spectralis™ OCT improved agreement for IRC and ERM, but not other retinal changes.

Conclusions:

• Spectralis™ OCT provides better inter-observer agreement for specific pathologies like IRC and ERM in neovascular AMD.
• The enhanced image resolution of Spectralis™ OCT positively impacts grading consistency for certain retinal features.
• OCT model choice may influence diagnostic accuracy and treatment decisions in AMD management.