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Intraobserver and Interobserver Agreement of Structural and Functional Software Programs for Measuring Glaucoma

Javier Moreno-Montañés1, Vanesa Antón1, Alfonso Antón2

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Glaucoma specialists showed substantial intraobserver agreement but only moderate interobserver agreement when using visual field (VF) and optical coherence tomography (OCT) software for glaucoma progression detection. The software alone is insufficient for clinical decision-making regarding treatment changes.

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Area of Science:

  • Ophthalmology
  • Medical Imaging
  • Glaucoma Research

Background:

  • Evaluating glaucoma progression is crucial for timely treatment adjustments.
  • Visual field (VF) testing and optical coherence tomography (OCT) are key diagnostic tools.
  • Software aids in analyzing VF and OCT data for progression detection.

Purpose of the Study:

  • To assess intraobserver and interobserver agreement among glaucoma specialists using VF and OCT progression software.
  • To determine if current software is sufficient for detecting glaucoma progression and guiding treatment decisions.

Main Methods:

  • Five glaucoma specialists independently reviewed randomized VF and OCT progression data from 100 patients.
  • Evaluations included classifying progression (none, questionable, or definite) and need for treatment change.
  • Intraobserver and interobserver agreement were quantified using kappa statistics and Gwet's second-order agreement coefficient.

Main Results:

  • Substantial to almost perfect intraobserver agreement was observed for both VF and OCT software.
  • Moderate interobserver agreement was found for both VF (κ=0.48) and OCT (κ=0.52) software.
  • Agreement was lower for cases with questionable or definite progression and for treatment change decisions.

Conclusions:

  • While intraobserver agreement is high, interobserver agreement using VF and OCT software is only moderate.
  • The software packages, when used alone, are insufficient for reliable detection of glaucoma progression and treatment decisions, especially in complex cases.
  • Further refinement or integration with clinical judgment is necessary for optimal glaucoma management.