Inter-Rater Reliability of Cyclotorsion Measurements Using Fundus Photography

Dysli, Muriel; Kanku, Madeleine; Traber, Ghislaine L.

doi:10.1055/s-0044-101013

Cited by 3 publications

(8 citation statements)

References 13 publications

(21 reference statements)

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“…Fundus photographs were obtained with the Zeiss camera (FF 450 plus, Jena, Germany) using an internal fixation target. Images were imported to synedra View (synedra View16, Version 16.0.0.11, Innsbruck, Austria) for the measurement of the FPA using the in-built tools of the software, as described previously (8).…”

Section: Methodsmentioning

confidence: 99%

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Cyclotorsion Measurement on Scanning Laser Ophthalmoscopy Imaging Compared With Fundus Photography in Patients With Fourth Nerve Palsy and Healthy Controls: CySLO-IV Study

Kanku¹,

Sele

Held

et al. 2020

Journal of Neuro-Ophthalmology

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Background:The purpose of the study is to evaluate the agreement of the foveopapillary angle (FPA) on conventional fundus photography (c-FPA) with the FPA on scanning laser ophthalmoscopy (SLO) imaging (SLO-FPA) in patients with fourth nerve palsy and healthy controls (HCs). Methods: The FPA was measured in both eyes of 25 patients and 25 HCs in synedra View (c-FPA) and with the integrated algorithm of the Heidelberg Spectralis OCT (SLO-FPA). The primary endpoint was the agreement of both measurements. Furthermore, we evaluated the influence of the eye tracker, the influence of fixation on objective torsion, and the FPA cutoff between patients and HCs. Results: The mean SLO-FPA in patients (6/25 acquired palsies) was 11.3 ± 3.6°and 6.4 ± 2.1°in HCs. The mean c-FPA was 11.4 ± 4.0°and 5.8 ± 2.2°, respectively. The Bland-Altman plot of c-FPA vs SLO-FPA in patients and HCs shows no systematic bias (mean of 20.28°). Limits of agreement were 26.58 and 6.02°. Using the eye tracker had no systematic effect. There was no evidence for an immediate shift of torsion with change of fixation (24/25 patients and 23/25 HCs). Discrimination between patients and HCs by the SLO-FPA is very good with an area under the curve = 0.92 (95% confidence interval: 0.84-0.99). Conclusions: SLO-FPA measurement allows convenient and consistent assessment of objective cyclotorsion. There was no systematic bias in the difference between SLO-FPA and traditional c-FPA; thus, SLO-FPA is a valuable alternative to the commonly used c-FPA. Using the eye tracker is recommended for proper centering of the ring scan.

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Section: Methodsmentioning

confidence: 99%

“…To compare the reliability of c-FPA and SLO-FPA measurements, 2 data sets (referred to as CyPhoto data set (8) and CySLO data set (7) in this article) from previous studies conducted at our institution were used. The reliability coefficient was calculated because it is independent of the within-group variance of the investigated variable.…”

Section: Methodsmentioning

confidence: 99%

Cyclotorsion Measurement on Scanning Laser Ophthalmoscopy Imaging Compared With Fundus Photography in Patients With Fourth Nerve Palsy and Healthy Controls: CySLO-IV Study

Kanku¹,

Sele

Held

et al. 2020

Journal of Neuro-Ophthalmology

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“…Investigations on cycloposition in healthy eyes described a mean value from 5.1° to 7.9° 4,9–11 and an estimated normality range from 0° to 13°; equivalent to the range described by Bixenman and von Noorden 1 . DFA can be measured by fundus photography software 4,6,9,10,12 or more recently with optical coherence tomography, 11,13,14 with the former method remaining the most frequently used.…”

Section: Introductionmentioning

confidence: 98%

“…Cycloposition is quantified by the inclination of a line connecting the fovea with the optic disc centre in relation to the horizon ( Figure ). It is called the disc‐fovea angle (DFA) and is considered the gold standard method for objective cycloposition measurement 4–8 . By convention, the DFA is positive when the fovea is below the optic disc centre and negative when it is above.…”

Section: Introductionmentioning

confidence: 99%

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Minimal detectable change of the disc‐fovea angle for ocular torsion assessment

Piedrahita-Alonso

Valverde-Megías

Martín-García

et al. 2021

Ophthalmic Physiologic Optic

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Purpose The disc‐fovea angle (DFA) is used as a relevant indicator of ocular torsion change in cyclovertical strabismus. However, interpretation of the variation in time must differentiate whether a real change has occurred or if the disparity is due to random measurement error. The aim of the study was to obtain the minimal detectable change (MDC) of the DFA. It represents the minimal variation between two measurements that may be considered a real ocular torsion change. Methods A prospective cross‐sectional study was conducted in San Carlos Clinical Hospital of Madrid, Spain. Sixty healthy right eyes from 60 patients (31 men and 29 women) were recruited. Three digital fundus photographs were obtained, and between measurements, the patient moved their head away from the head support and then returned. Two observers quantified the DFA with software designed with MATLAB. Test‐retest and interrater reliability were calculated. Results Mean participant age was 56.1 years (SD 16.6, range 25–85). Mean DFA was 8.1° (SD 3.5, range 1.3–18.5). Test‐retest reliability for Observer 1 (Ob1), Observer 2 (Ob2) and interrater reliability were excellent (ICC 0.80, 0.83 and 0.95, respectively). Precision was 2.9° (Ob1) and 3.0° (Ob2), and the MDC95 was 4.1° (Ob1) and 4.2° (Ob2). Bland‐Altman analysis revealed an absence of bias and a homoscedastic distribution of the differences. Conclusions The MDC of the DFA in fundus photography was 4°, which represents the minimal change that may be considered a real change in ocular torsion. This result may improve the interpretation of ocular torsion changes in surgery and clinical scenarios.

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Validity and Reliability of Semiautomatic Ocular Cycloposition Measurement With Spectralis Optical Coherence Tomography

Piedrahita-Alonso

Valverde-Megías

Gómez-de-Liaño

2021

American Journal of Ophthalmology

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Inter-Rater Reliability of Cyclotorsion Measurements Using Fundus Photography

Abstract: The inter-rater reliability of objective cyclotorsion measurements using fundus photographs was very high.

Cited by 3 publications

References 13 publications

Cyclotorsion Measurement on Scanning Laser Ophthalmoscopy Imaging Compared With Fundus Photography in Patients With Fourth Nerve Palsy and Healthy Controls: CySLO-IV Study

Cyclotorsion Measurement on Scanning Laser Ophthalmoscopy Imaging Compared With Fundus Photography in Patients With Fourth Nerve Palsy and Healthy Controls: CySLO-IV Study

Minimal detectable change of the disc‐fovea angle for ocular torsion assessment

Validity and Reliability of Semiautomatic Ocular Cycloposition Measurement With Spectralis Optical Coherence Tomography

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