RETINAL VASCULITIS SEVERITY ASSESSMENT: Intraobserver and Interobserver Reliability of a New Scheme for Grading Wide-Field Fluorescein Angiograms in Retinal Vasculitis
Issued Date
2023-09-01
Resource Type
eISSN
15392864
Scopus ID
2-s2.0-85168784551
Pubmed ID
37229721
Journal Title
Retina (Philadelphia, Pa.)
Volume
43
Issue
9
Start Page
1534
End Page
1543
Rights Holder(s)
SCOPUS
Bibliographic Citation
Retina (Philadelphia, Pa.) Vol.43 No.9 (2023) , 1534-1543
Suggested Citation
Dhirachaikulpanich D., Madhusudhan S., Parry D., Babiker S., Zheng Y., Beare N.A.V. RETINAL VASCULITIS SEVERITY ASSESSMENT: Intraobserver and Interobserver Reliability of a New Scheme for Grading Wide-Field Fluorescein Angiograms in Retinal Vasculitis. Retina (Philadelphia, Pa.) Vol.43 No.9 (2023) , 1534-1543. 1543. doi:10.1097/IAE.0000000000003838 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/89161
Title
RETINAL VASCULITIS SEVERITY ASSESSMENT: Intraobserver and Interobserver Reliability of a New Scheme for Grading Wide-Field Fluorescein Angiograms in Retinal Vasculitis
Other Contributor(s)
Abstract
PURPOSE: Wide-field fluorescein angiography is commonly used to assess retinal vasculitis (RV), which manifests as vascular leakage and occlusion. Currently, there is no standard grading scheme for RV severity. The authors propose a novel RV grading scheme and assess its reliability and reproducibility. METHODS: A grading scheme was developed to assess both leakage and occlusion in RV. Wide-field fluorescein angiography images from 50 patients with RV were graded by four graders, and one grader graded them twice. An intraclass correlation coefficient (ICC) was used to determine intraobserver-interobserver reliability. Generalized linear models were calculated to associate the scoring with visual acuity. RESULTS: Repeated grading by the same grader showed good intraobserver reliability for both leakage (ICC = 0.85, 95% CI 0.78-0.89) and occlusion (ICC = 0.82, 95% CI 0.75-0.88) scores. Interobserver reliability among four independent graders showed good agreement for both leakage (ICC = 0.66, 95% CI 0.49-0.77) and occlusion (ICC = 0.75, 95% CI 0.68-0.81) scores. An increasing leakage score was significantly associated with worse concurrent visual acuity (generalized linear models, β = 0.090, P < 0.01) and at 1-year follow-up (generalized linear models, β = 0.063, P < 0.01). CONCLUSION: The proposed grading scheme for RV has good to excellent intraobserver and interobserver reliability across a range of graders. The leakage score related to present and future visual acuity.