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Interobserver agreement in the evaluation of acute retinal artery occlusion
S Sharma1, M W ten Hove, R M Pinkerton
1Department of Ophthalmology, Queen's University, Kingston, Ont.
Objective:
To determine the agreement between two ophthalmologists in the evaluation of two important funduscopic features related to acute retinal artery occlusion: retinal cloudy swelling and visible retinal emboli.
Design:
An interobserver variability study in which two ophthalmologists (one trained in glaucoma, the other in neuro-ophthalmology) independently viewed fundus photographs and categorized them with respect to the presence or absence of cloudy swelling and retinal emboli. Inter- and intraobserver agreement was calculated with the kappa statistic.
Setting:
Retina service at a university-affiliated hospital in Kingston, Ont.
Patients:
The fundus photographs of 102 patients were included: 60 with acute retinal artery occlusion, 30 with conditions mimicking acute retinal artery occlusion and 12 healthy patients.
Results:
Both interobserver and intraobserver agreement as to the presence of retinal cloudy swelling were very high (kappa = 0.835 and 0.866 respectively). More variability was seen for the presence of retinal emboli, but, overall, interobserver and intraobserver agreement were still high (kappa = 0.726 and 0.629 respectively).
Conclusions:
Our results suggest that clinicians use similar visual clues to categorize fundi with respect to retinal cloudy swelling and visible retinal emboli.