DIGITAL TEARSCOPE IMAGING USING THE EYECAP OPHTHALMIC IMAGE CAPTURE SYSTEM: PERFORMANCE AND AGREEMENT BETWEEN EXAMINERS

Brian Puent

Abstract

PURPOSE. Our purpose was to compare the agreement within and between two examiners when evaluating real-time and digital images of TearScope tear patterns. We also compared between examiner agreement of non-invasive digital tear break-up time (TBUT) using the TearScope. METHOD. Twenty normal patients were seen for digital imaging of the tear film using the TearScope mounted on a slit-lamp with the EyeCap Ophthalmic Image Capture System. Two observers first assessed the tear pattern (e.g. closed meshwork) independently in real-time. Tear film digital images were then captured using TearScope illumination until the first visible break-up of the tears or until the first blink occurred. All patient image series were randomized and then evaluated by two independent and masked examiners. The weighted Kappa statistic (kw) was used to determine within examiner reliability and between examiner agreement when grading tear patterns. The mean difference between examiners and 95% limits of agreement (95% LoA) were used to assess the agreement between examiners when evaluating the digital images series used for noninvasive TBUT.

RESULTS. Comparison of real-time and digital tear pattern grading within examiners showed moderate agreement (kwExaminer1 = 0.53 and kwExaminer2 = 0.47). The agreement between examiners when grading tear patterns was also moderate in real-time (kwBetween = 0.59) and in the digital image series (kwBetween = 0.41). The mean difference in digital TBUT between examiners was -3.45 seconds (95% LoA = - 9.12 to 2.22 seconds) CONCLUSIONS. There was moderate agreement within examiners when comparing real-time and digital tear patterns using the TearScope. Surprisingly, better agreement existed between examiners when grading real-time tear patterns as compared to digital images of the tear patterns using the TearScope. These results suggest the need for continued product and technique development, although the future use of the TearScope with digital imaging is promising.

Details

Year: 2001

Program Number: Poster 123

Author Affiliation: The Ohio State University

Co-Authors: Mario Saracino, Jason Nichols, Kelly Nichols

Co-Author Affiliation: The Ohio State University, The Ohio State University, The Ohio State University

Room: Exhibit Hall C