The International Classification system and the progression of age-related macular degeneration.
Details
Serval ID
serval:BIB_BB7A93636226
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
The International Classification system and the progression of age-related macular degeneration.
Journal
Current eye research
ISSN
1460-2202 (Electronic)
ISSN-L
0271-3683
Publication state
Published
Issued date
03/2009
Peer-reviewed
Oui
Volume
34
Number
3
Pages
238-240
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Publication Status: ppublish
Abstract
To determine whether grading based on the International Classification (IC) for age-related macular degeneration (AMD) allows recognition of change during the progression of the disease.
Stereoscopic color fundus photographs of 50 eyes of 25 patients with AMD and at least 5 years of review were graded in a random and masked fashion for changes over time in the characteristics of drusen, pigmentary changes, and end-stage disease, according to the system defined by the IC for AMD, by two independent graders (F.B.S., I.L.). Fundus images were also analyzed in time sequence for clinical changes by a senior grader (I.L.) and two ophthalmologists (A.C.B., T.P.) without access to the grading forms of the IC grading. Clinical change, as recorded by the IC grading and the individual analysis, were compared.
There was 97.8% (kappa = 0.70) concordance in identification of change. In four cases, the clinical classification differed from the IC grading: Two cases of drusen and two of end-stage disease grading. Inter-observer agreement for the IC grading was 89.4% for predominant phenotype (kappa = 0.84), 89.36-91.49% for presence of choroidal neovascularization (CNV) (kappa = 0.79-0.83), 87.23-89.36% for geographic atrophy (GA) (kappa = 0.62-0.74) and 55.32% for area covered by drusen (kappa = 0.31).
Overall, progression from earlier stages of AMD to either of the two forms of advanced AMD were reflected accurately by the IC grading in the vast majority of cases.
Stereoscopic color fundus photographs of 50 eyes of 25 patients with AMD and at least 5 years of review were graded in a random and masked fashion for changes over time in the characteristics of drusen, pigmentary changes, and end-stage disease, according to the system defined by the IC for AMD, by two independent graders (F.B.S., I.L.). Fundus images were also analyzed in time sequence for clinical changes by a senior grader (I.L.) and two ophthalmologists (A.C.B., T.P.) without access to the grading forms of the IC grading. Clinical change, as recorded by the IC grading and the individual analysis, were compared.
There was 97.8% (kappa = 0.70) concordance in identification of change. In four cases, the clinical classification differed from the IC grading: Two cases of drusen and two of end-stage disease grading. Inter-observer agreement for the IC grading was 89.4% for predominant phenotype (kappa = 0.84), 89.36-91.49% for presence of choroidal neovascularization (CNV) (kappa = 0.79-0.83), 87.23-89.36% for geographic atrophy (GA) (kappa = 0.62-0.74) and 55.32% for area covered by drusen (kappa = 0.31).
Overall, progression from earlier stages of AMD to either of the two forms of advanced AMD were reflected accurately by the IC grading in the vast majority of cases.
Keywords
Disease Progression, Follow-Up Studies, Humans, International Classification of Diseases, Macula Lutea/pathology, Macular Degeneration/classification, Macular Degeneration/physiopathology, Phenotype, Photography
Pubmed
Web of science
Create date
26/09/2024 20:11
Last modification date
27/09/2024 16:46