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Randomized Controlled Trial
. 2010 Sep;128(9):1140-5.
doi: 10.1001/archophthalmol.2010.193.

Standard Care vs Corticosteroid for Retinal Vein Occlusion (SCORE) Study system for evaluation of stereoscopic color fundus photographs and fluorescein angiograms: SCORE Study Report 9

Barbara A Blodi  1 , Amitha Domalpally, Ingrid U Scott, Michael S Ip, Neal L Oden, Julee Elledge, Kelly Warren, Michael M Altaweel, Judy E Kim, Paul C Van Veldhuisen; SCORE Study Research Group
Affiliations
Randomized Controlled Trial

Standard Care vs Corticosteroid for Retinal Vein Occlusion (SCORE) Study system for evaluation of stereoscopic color fundus photographs and fluorescein angiograms: SCORE Study Report 9

Barbara A Blodi et al. Arch Ophthalmol. 2010 Sep.

Abstract

Objective: To describe the procedures and reproducibility for grading stereoscopic color fundus photographs and fluorescein angiograms of participants in the SCORE Study.

Methods: Standardized stereoscopic fundus photographs and fluorescein angiograms taken at 84 clinical centers were evaluated by graders at a central reading center. Type of retinal vein occlusion (RVO), area of retinal thickening, and area of retinal hemorrhage are evaluated from fundus photographs; area of fluorescein leakage and area of capillary nonperfusion are measured on fluorescein angiography. Temporal reproducibility consisted of annual regrading of a randomly selected dedicated subset of fundus photographs (60 subjects) and fluorescein angiograms (40 subjects) for 3 successive years. Contemporaneous reproducibility involved monthly regrading of a 5% random selection of recently evaluated fundus photographs (n = 73).

Results: The intergrader agreement for RVO type and presence of retinal thickening was greater than 90% in the 3 annual regrades. The intraclass correlation (ICC) for area of retinal thickening in the 3 years ranged from 0.39 to 0.64 and for area of retinal hemorrhage, 0.87 to 0.96. The ICC for area of fluorescein leakage ranged from 0.66 to 0.75 and for capillary nonperfusion, 0.94 to 0.97. The contemporaneous reproducibility results were similar to those of temporal reproducibility for all variables except area of retinal thickening (ICC, 0.84).

Conclusions: The fundus photography and fluorescein angiography grading procedures for the SCORE Study are reproducible and can be used for multicenter longitudinal studies of RVO. A systematic temporal drift occurred in evaluating area of retinal thickening.

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Figures

Figure 1
Figure 1
Color grading of retinal vein occlusion. A, Evaluation of type of retinal vein occlusion using the quadrant grid. B, Evaluation of retinal thickening and retinal hemorrhages within the Early Treatment for Diabetic Retinopathy Study grid.
Figure 2
Figure 2
Evaluation of area of capillary nonperfusion. Early phase images (A) and area of fluorescein leakage from late phase images (B). The Early Treatment for Diabetic Retinopathy Study grid is overlaid on the field 2 image for area estimation in each subfield. Arrows indicate capillary nonperfusion.
Figure 3
Figure 3
Scatterplots comparing the 3 annual regrades with the original grade of record. A, Reproducibility for area of retinal thickening in disc areas. B, Reproducibility for area of retinal hemorrhage in disc areas. C, Reproducibility for area of fluorescein leakage in disc areas. D, Reproducibility for area of capillary loss in disc areas.
See this image and copyright information in PMC

References

    1. Ip MS, Oden NL, Scott IU, et al. SCORE Study Investigator Group. SCORE Study report 3: study design and baseline characteristics. Ophthalmology. 2009;116(9):1770–1777. e1. - PMC - PubMed
    1. Domalpally A, Blodi BA, Scott IU, et al. SCORE Study Investigator Group. The Standard Care vs Corticosteroid for Retinal Vein Occlusion (SCORE) study system for evaluation of optical coherence tomograms: SCORE study report 4. Arch Ophthalmol. 2009;127(11):1461–1467. - PMC - PubMed
    1. Fundus Photograph Reading Center Grading Forms for the Standard Care vs. Corticosteroid for Retinal Vein Occlusion (SCORE) Study. NTIS order No. PB2008–113740. Bethesda, MD: National Eye Institute;
    1. Early Treatment Diabetic Retinopathy Study Research Group. Grading diabetic retinopathy from stereoscopic color fundus photographs: an extension of the modified Airlie House classification–ETDRS report number 10. Ophthalmology. 1991;98(5 suppl):786–806. - PubMed
    1. Early Treatment Diabetic Retinopathy Study Research Group. Classification of diabetic retinopathy from fluorescein angiograms: ETDRS report number 11. Ophthalmology. 1991;98(5 suppl):807–822. - PubMed

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