Optical coherence tomography image grading agreement between observers in neovascular age‐related macular degeneration

Abstract

Abstract Purpose Time‐domain optical coherence tomography (TD‐OCT) became an important tool for the management of neovascular age‐related macular degeneration (AMD). Recently, spectral‐domain OCT (SD‐OCT) became available with improved image resolution and scanning speed. The purpose of this study was to compare inter‐observer agreement of SD‐OCT versus TD‐OCT image grading in patients with exudative AMD. Methods Thirty eyes with neovascular AMD were examined with 2 different OCT models. Three observers graded fast macular scans (FMS), cross hair scans (CHS) (both Stratus™ OCT), volume scans (VS), and radial line scans (RLS) (both Spectralis™ OCT) for the presence of various morphologic pathologies. Inter‐observer agreement between OCT models was assessed by calculating intra‐class correlation coefficients (ICC). Results In Stratus™ OCT highest agreement was found for subretinal fluid (ICC: 0.79), and in Spectralis™ OCT for intraretinal cysts (IRC) (ICC: 0.93). Spectralis™ OCT showed superior agreement for IRC and epiretinal membranes (ERM) (ICCStratus™ : for IRC 0.61; for ERM 0.56; ICCSpectralis™ : for IRC 0.93; for ERM 0.84). Lowest agreement was found for subretinal fibrosis (FIB) with an ICCStratus™ of 0.65, and an ICCSpectralis™ of 0.52. Spectralis™ Conclusion Increased image resolution of Spectralis™ OCT did not markedly improve the inter‐observer agreement except for grading intraretinal cysts and epiretinal membranes.