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Randomized Controlled Trial
. 2011 Aug;19(4):267-74.
doi: 10.3109/09273948.2011.583376.

Morphologic assessment for glaucoma in the Multicenter Uveitis Steroid Treatment (MUST) trial

Sapna S Gangaputra  1 , Michael M Altaweel, Qian Peng, David S Friedman, P Kumar Rao, C Stephen Foster, Rosa Y Kim, Susan B Reed, Sunil K Srivastava, Ira G Wong, John H Kempen; MUST Trial Research Group
Collaborators, Affiliations
Randomized Controlled Trial

Morphologic assessment for glaucoma in the Multicenter Uveitis Steroid Treatment (MUST) trial

Sapna S Gangaputra et al. Ocul Immunol Inflamm. 2011 Aug.

Abstract

Purpose: To compare Reading Center (RC) cup-to-disc ratio (CDR) assessment from stereoscopic photographs with clinician estimation in a uveitis clinical trial.

Methods: Clinical estimation of CDR was performed by ophthalmologists via dilated biomicroscopy. Photographic evaluation was performed at an independent RC by masked, certified evaluators. Quality control was performed by repeat grading of 77 randomly selected images.

Results: Among 479 eyes with uveitis, 353 eyes had clinical and photographic grades for CDR. Agreement between clinical and RC grading was fair, with exact agreement of 29%. Agreement within 0.1 and 0.2 CDR was 70 and 93%, respectively (weighted κ = .34). Intergrader reproducibility at the RC was better (weighted κ = .59, ICC 0.74).

Conclusion: Morphologic assessment of cup to disc ratio is an important outcome and safety measure for determining glaucomatous damage in clinical trials. Masked RC measurements are more likely to be accurate than biomicroscopic grading in identifying meaningful anatomical change associated with glaucoma.

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Conflict of interest statement

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper

Figures

Figure 1
Figure 1
Comparison of cup-disc ratios between reading center grades and clinician
Figure 2
Figure 2
Reproducibility of cup-disc ratio grades at the reading center.
See this image and copyright information in PMC

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