Dr.SHRUTI NITIN SHAH, S20413
Purpose: To study the agreement between ophthalmolologists of varying experiences in grading large discs as glaucomatous or not
Methods:
Stereo disc photographs and SS OCT of 89 eyes were studied. Glaucoma experts (2), glaucoma fellows (2) and fresh graduates (2) graded the discs as glaucomatous or not based on their clinical judgement. OCTs were used to define disc size. Agreement was calculated by using kappa statistic.
Results:
The kappa values for glaucoma experts,glaucoma fellows and post graduates were 0.41,0.38 and -0.23. The disc areas were stratified as area<2,2-2.5,2.5-3,>3 mm2. The K value for disc area<2 mm2 was 0.069,0.571,0.182; area between 2-2.5 mm2 was 0.553,0.341,0.016; area between 2.5-3mm2 was 0.387,0.091,-0.081 and area >3mm2 was 0.458,0.491,-0189
Conclusion:
Agreement improves with increasing level of specialisation. Better protocols in training individuals to identify disc and nerve fiber layer changes would be helpful.
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