Scale for Photographic Grading of Vitreous Haze in Uveitis

Abstract

PURPOSE To validate a scale for grading vitreous haze in uveitis using digitized photographs and standardized scoring. DESIGN Evaluation of clinical research methodology. METHODS Calibrated Bangerter diffusion filters inducing incremental decrements of spatial contrast were placed in front of the camera lens while photographing a normal eye to simulate vitreous haze. The photographs were digitized and an ordinal scale was created from 0 (none) to 8 (highest level of opacification at which fundus details could be seen). The scale steps correspond approximately to decimal Snellen visual acuities of 1.0, 0.8, 0.4, 0.2, 0.1, 0.04, 0.02, 0.01, and 0.002, with approximately 0.3 log step between each step. For validation, digitized fundus photographs of uveitis patients were displayed on a computer monitor for comparison with the standard photos. Three observers graded the test set twice under standard conditions. Interobserver and intraobserver variability and κ values for agreement greater than chance were calculated. RESULTS Variance component analysis determined that 87.7% of the variance in grades was attributable to the test item rather than to grader or session. The intraclass correlation between graders and grading sessions varied from 0.84 to 0.91. Simple agreement within 1 grade between graders and sessions occurred in 90 ± 5.5% of gradings. κ values averaged 0.91, which is considered near perfect. CONCLUSIONS A 9-step photographic scale was designed to standardize the grading of vitreous haze in uveitis patients using fundus photographs. The scale is potentially adaptable to clinical trials in uveitis.

Use of intravitreal bevacizumab or triamcinolone acetonide as a preoperative adjunct to vitrectomy for vitreous haemorrhage in diabetics

“…At each visit, complete ophthalmologic examinations were performed. The graduation of VH was done by indirect fundus examination using the classification above (clinical findings) and this findings evaluated by the score changes during the visits (19) . Exclusion criteria were: tractional retinal detachment, tractional-rhegmatogenous retinal detachment, previous (19) .…”

A 26-year-old man with a blind spot in his left eye

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Measurement Reliability of Axial Length of the Human Eye by using Partial Coherence Interferometry

“…The following parameters were analyzed: preoperative visual acuity (logarithm of the minimum angle of resolution, logMAR); lens opacity graded as LOCS III [13]; and vitreous opacity graded using the vitreous haze scale for photographic grading of vitreous haze in uveitis from 0 (none) to 8, with approximately 0.3 log step between each step. [14] …”