Assessment of the reproducibility and repeatability of a method of grading macular subretinal fluid using optical coherence tomography

Abstract

Aim To devise a quantative method for the measurement of the extent of macular subretinal fluid using optical coherence tomography (OCT), and to assess the interobserver and intraobserver agreement for this grading system. Methods Observational cohort series. Patients were a cohort who underwent retinal detachment surgery over an 18-month period. All patients had OCT scan at 6 weeks after surgery. The scans were graded by two independent observers experienced in OCT interpretation and each grader was masked to the others findings. Observer 1 then regraded the scans on a later day masked to his previous findings. The interobserver and intraobserver agreement was assessed using weighted Kappa (Kw) statistics. Results In all, 116 patients were analysed. Both the intraobserver and interobserver agreement was very high, with Kw being 0.9631 and 0.9070, respectively. Conclusions The grading system for assessment of the extent of macular subretinal fluid using OCT appears to have very good reproducibility and repeatability. We propose that this grading system would be clinically useful when applied to pathologies visible on OCT scan of the macula.

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Technical Note: Method for estimating volume of subretinal fluid in cases of localized retinal detachment by OCT ophthalmoscopy

“…Unfortunately, the resolution of ultrasound is not as high as the OCT Ophthalmoscope, and it would be difficult to measure the volume of the subretinal fluid in cases of CSC or AMD by ultrasonography. Benson et al (2006) reported on a method of grading the area of subretinal fluid using the six OCT B scan images, but they did not calculate the volume of the subretinal fluid. The vertical cursor line had a step-like pattern (see green vertical line of Figure 5) after we moved the horizontal cursor line, and this must introduce a small amount of error.…”

“…In these studies, the actual volume was not measured (Montero et al. , 2003; Abouzeid and Wolfensberger, 2006; Benson et al. , 2006).…”

“…There are several studies that analysed the amount of subretinal fluid in macular and retinal diseases, but most of them used a single or several B scan OCT images to estimate the volume, area, height or the existence of a subretinal space or fluid. In these studies, the actual volume was not measured (Montero et al, 2003;Abouzeid and Wolfensberger, 2006;Benson et al, 2006).…”