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Fundus image diagnostic agreement in uveitis utilizing free and open source software.
Jane Hsieh1, Andrea F Honda, Mayte Suárez-Fariñas
1New York Eye and Ear Infirmary, New York, NY, USA.
Summary
Image agreement for uveitis diagnosis using only fundus and fluorescein angiography was poor. Specialists need more clinical data for accurate diagnosis, highlighting limitations of imaging alone in uveitis assessment.
Area of Science:
- Ophthalmology
- Medical Imaging
- Uveitis Diagnosis
Background:
- Uveitis diagnosis often relies on clinical expertise and imaging.
- Assessing interobserver agreement is crucial for diagnostic reliability.
Purpose of the Study:
- To evaluate the agreement of uveitis diagnoses based solely on color fundus and fluorescein angiography images.
- To explore the utility of free and open-source applications in ophthalmic image agreement studies.
Main Methods:
- A cross-sectional agreement study was conducted.
- Three uveitis specialists independently reviewed patient images using ClearCanvas™ and responded via Epi Info™.
- Interobserver agreement was assessed using the kappa (κ) coefficient, with bootstrapping for confidence intervals.
Main Results:
- Poor agreement was found between reviewers and the gold standard (κ = 0.09) and among reviewers (κ = 0.11).
- Specialists indicated a need for additional patient historical and clinical information for diagnosis.
- Free and open-source software demonstrated utility in conducting the agreement study.
Conclusions:
- Fundus imaging alone has limited utility in differentiating uveitis conditions.
- Future research should incorporate diverse clinical data to supplement imaging findings.
- Open-source applications are valuable tools for ophthalmic imaging agreement research.
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