TY - JOUR
T1 - The Age-Related Eye Disease Study (AREDS) system for classifying cataracts from photographs
T2 - AREDS Report No. 4
AU - The Age-Related Eye Disease Study Research Group
AU - Kassoff, Aaron
AU - Kassoff, Jordan
AU - Mehu, Michel
AU - Buehler, Jo Anne
AU - Eglow, Mary
AU - Kaufman, Francine
AU - Kieval, Shalom
AU - Margherio, Raymond R.
AU - Cox, Morton S.
AU - Garretson, Bruce
AU - Hassan, Tarek
AU - Ruby, Alan
AU - Trese, Michael T.
AU - Werner, Jane Camille
AU - Williams, George A.
AU - Regan, Virginia
AU - Manatrey, Patricia
AU - Cumming, Kristi
AU - Lewis, Bobbie
AU - Zajechowski, Mary
AU - Falk, Rachel
AU - Streasick, Patricia
AU - Szydlowski, Lynette
AU - McIver, Fran
AU - Bridges, Craig
AU - Stanley, Cheryl
AU - Klein, Michael L.
AU - Robertson, Joseph E.
AU - Wilson, David J.
AU - Beardsley, Carolyn
AU - Smith, Garland
AU - Howard, Shannon
AU - Dreyer, Richard F.
AU - Ma, Colin
AU - Chenoweth, Richard G.
AU - Zilis, John D.
AU - Crider, Harold
AU - Parker, Sheryl
AU - Sherman, Kathryn
AU - Martin, Daniel
AU - Aaberg, Thomas M.
AU - Sternberg, Paul
AU - Curtis, Linda
AU - Gilman, James
AU - Myles, Bob
AU - Armiger, Denise
AU - Capone, Antonio
AU - Saperstein, David
AU - Stribling, Barbara
AU - Swords, Ray
N1 - Funding Information:
Supported by contracts from the National Eye Institute, National Institutes of Health, Bethesda, Maryland.
PY - 2001
Y1 - 2001
N2 - PURPOSE: To describe the system for grading cataracts from photographs in the Age-Related Eye Disease Study (AREDS). METHODS: The system for grading cataracts in AREDS uses photographs taken in a standardized fashion with specially modified cameras at 11 clinical centers. The photographs are evaluated by graders for quality and cataract severity at a central reading center. The area of lens involvement is used to assess the severity of cortical and posterior subcapsular opacities. Optical density of nuclear opacity is graded against a series of seven standard photographs. Contemporaneous variability in grading is evaluated periodically by having a second examiner regrade a subset of the photographs. Temporal variability is assessed by annually regrading a subset of photographs. RESULTS: Photographs of 925 eyes, most with no or early lens opacities, were regraded to assess intergrader reliability. For cortical opacities, there was an absolute difference of 10% or greater of area involved in 1.9% of the replicate gradings. For posterior subcapsular opacities an absolute difference of 5% of area involved was noted in 2.8% of the regraded photographs. For nuclear opacities, absolute differences of 1.5 or more steps were observed in 0.6% of eyes. There was little evidence of temporal drift in grading any of the three types of opacity during four annual regrades. CONCLUSIONS: We have demonstrated a high degree of reliability in grading the severity of lens opacities in a large study cohort with mostly early lens changes, the type of cohort most likely to be entered in clinical trials involving cataract prevention. The Age-Related Eye Disease Study System for Classifying Cataracts From Photographs could be useful in studies where there is a need to standardize data collection over time and across different data collection sites. Limitations of the system include the cost of implementation and, currently, the limited amount of data on grading reproducibility for more advanced lens opacities.
AB - PURPOSE: To describe the system for grading cataracts from photographs in the Age-Related Eye Disease Study (AREDS). METHODS: The system for grading cataracts in AREDS uses photographs taken in a standardized fashion with specially modified cameras at 11 clinical centers. The photographs are evaluated by graders for quality and cataract severity at a central reading center. The area of lens involvement is used to assess the severity of cortical and posterior subcapsular opacities. Optical density of nuclear opacity is graded against a series of seven standard photographs. Contemporaneous variability in grading is evaluated periodically by having a second examiner regrade a subset of the photographs. Temporal variability is assessed by annually regrading a subset of photographs. RESULTS: Photographs of 925 eyes, most with no or early lens opacities, were regraded to assess intergrader reliability. For cortical opacities, there was an absolute difference of 10% or greater of area involved in 1.9% of the replicate gradings. For posterior subcapsular opacities an absolute difference of 5% of area involved was noted in 2.8% of the regraded photographs. For nuclear opacities, absolute differences of 1.5 or more steps were observed in 0.6% of eyes. There was little evidence of temporal drift in grading any of the three types of opacity during four annual regrades. CONCLUSIONS: We have demonstrated a high degree of reliability in grading the severity of lens opacities in a large study cohort with mostly early lens changes, the type of cohort most likely to be entered in clinical trials involving cataract prevention. The Age-Related Eye Disease Study System for Classifying Cataracts From Photographs could be useful in studies where there is a need to standardize data collection over time and across different data collection sites. Limitations of the system include the cost of implementation and, currently, the limited amount of data on grading reproducibility for more advanced lens opacities.
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U2 - 10.1016/S0002-9394(00)00732-7
DO - 10.1016/S0002-9394(00)00732-7
M3 - Article
C2 - 11228291
AN - SCOPUS:0035133854
SN - 0002-9394
VL - 131
SP - 167
EP - 175
JO - American journal of ophthalmology
JF - American journal of ophthalmology
IS - 2
ER -