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Bleb grading by photographs versus bleb grading by slit-lamp examination
Esther M Hoffmann1, Daniel Herzog1, Joanna Wasielica-Poslednik1
1Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University, Mainz, Germany.
Acta Ophthalmologica
|January 1, 2020
Summary
The Mainz Bleb Appearance Grading System (MaBAGS) demonstrates good reproducibility for evaluating glaucoma surgery blebs. Clinical grading via slit-lamp examination is more reliable than using photographs for these assessments.
Area of Science:
- Ophthalmology
- Glaucoma Surgery
- Surgical Outcomes
Background:
- Glaucoma surgery requires long-term follow-up.
- Evaluating filtering blebs post-trabeculectomy can be challenging.
- Bleb morphology influences patient prognosis and follow-up planning.
Purpose of the Study:
- Compare the Mainz Bleb Appearance Grading System (MaBAGS) with other systems (MBGS, IBAGS).
- Assess the usability and reliability of MaBAGS for bleb grading.
- Evaluate grading accuracy using clinical examination versus photographic review.
Main Methods:
- Included 42 eyes from 31 patients post-trabeculectomy.
- Three observers (two senior, one junior) graded blebs using MaBAGS, MBGS, and IBAGS.
- Compared clinical grading with grading from bleb photographs taken at least 4 weeks prior.
Main Results:
- MaBAGS showed excellent agreement for vascularity, Seidel test, and transparency.
- Moderate agreement was found for area and height with MaBAGS.
- Interobserver agreement was consistently better for experienced observers across all systems.
- Slit-lamp examination grading reliability surpassed photographic grading.
Conclusions:
- MaBAGS exhibits good reproducibility for bleb assessment.
- Standardized grading systems enhance the precision of describing variable clinical findings.
- Clinical slit-lamp examination is superior to photographic grading for bleb evaluation.
