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Abstract #95040 Published in IGR 22-2
Interobserver and Intertest Agreement in Telemedicine Glaucoma Screening with Optic Disk Photos and Optical Coherence Tomography
Anton A; Nolivos K; Pazos M; Fatti G; Herranz A; Ayala-Fuentes ME; Martínez-Prats E; Peral O; Vega-Lopez Z; Monleon-Getino A; Morilla-Grasa A; Comas M; Castells XJournal of clinical medicine 2021; 10:
: To evaluate interobserver and intertest agreement between optical coherence tomography (OCT) and retinography in the detection of glaucoma through a telemedicine program. : A stratified sample of 4113 individuals was randomly selected, and those who accepted underwent examination including visual acuity, intraocular pressure (IOP), non-mydriatic retinography, and imaging using a portable OCT device. Participants' data and images were uploaded and assessed by 16 ophthalmologists on a deferred basis. Two independent evaluations were performed for all participants. Agreement between methods was assessed using the kappa coefficient and the prevalence-adjusted bias-adjusted kappa (PABAK). We analyzed potential factors possibly influencing the level of agreement. : The final sample comprised 1006 participants. Of all suspected glaucoma cases ( = 201), 20.4% were identified in retinographs only, 11.9% in OCT images only, 46.3% in both, and 21.4% were diagnosed based on other data. Overall interobserver agreement outcomes were moderate to good with a kappa coefficient of 0.37 and a PABAK index of 0.58. Higher values were obtained by experienced evaluators (kappa = 0.61; PABAK = 0.82). Kappa and PABAK values between OCT and photographs were 0.52 and 0.82 for the first evaluation. : In a telemedicine screening setting, interobserver agreement on diagnosis was moderate but improved with greater evaluator expertise.
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