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Validity of a new optic disc grading software for use in clinical and epidemiological research
Yih-Chung Tham1, Carol Y Cheung, Tien Y Wong
1Singapore Eye Research Institute, Singapore National Eye Centre, Singapore; Department of Ophthalmology, Yong Loo Lin School of Medicine, Singapore.
Background:
To determine the reliability and agreement of a new optic disc grading software program for use in clinical, epidemiological research.
Design:
Reliability and agreement study.
Samples:
328 monoscopic and 85 stereoscopic optic disc images.
Methods:
Optic disc parameters were measured using a new optic disc grading software (Singapore Optic Disc Assessment) that is based on polynomial curve-fitting algorithm. Two graders independently graded 328 monoscopic images to determine intergrader reliability. One grader regraded the images after 1 month to determine intragrader reliability. In addition, 85 stereo optic disc images were separately selected, and vertical cup-to-disc ratios were measured using both the new software and standardized Wisconsin manual stereo-grading method by the same grader 1 month apart. Intraclass correlation coefficient (ICC) and Bland-Altman plot analyses were performed.
Main Outcome Measures:
Optic disc parameters.
Results:
The intragrader and intergrader reliability for optic disc measurements using Singapore Optic Disc Assessment was high (ICC ranging from 0.82 to 0.94). The mean differences (95% limits of agreement) for intergrader vertical cup-to-disc ratio measurements were 0.00 (-0.12 to 0.13) and 0.03 (-0.15 to 0.09), respectively. The vertical cup-to-disc ratio agreement between the software and Wisconsin grading method was extremely close (ICC = 0.94). The mean difference (95% limits of agreement) of vertical cup-to-disc ratio measurement between the two methods was 0.03 (-0.09 to 0.16).
Conclusions:
Intragrader and intergrader reliability using Singapore Optic Disc Assessment was excellent. This software was highly comparable with standardized stereo-grading method. Singapore Optic Disc Assessment is useful for grading digital optic disc images in clinical, population-based studies.
