The Age-Related Eye Disease Study (AREDS) system for classifying cataracts from photographs: AREDS Report No. 4

A. Kassoff, J. Kassoff, M. Mehu, J. A. Buehler, M. Eglow, F. Kaufman, S. Kieval, R. R. Margherio, M. S. Cox, B. Garretson, T. Hassan, A. Ruby, M. T. Trese, J. C. Werner, G. A. Williams, V. Regan, P. Manatrey, K. Cumming, B. Lewis, M. ZajechowskiR. Falk, P. Streasick, L. Szydlowski, F. McIver, C. Bridges, C. Stanley, Michael Klein, Joseph Robertson, David Wilson, C. Beardsley, G. Smith, S. Howard, R. F. Dreyer, C. Ma, R. G. Chenoweth, J. D. Zilis, H. Crider, S. Parker, D. Martin, Jr Aaberg T.M., Jr Sternberg P., L. Curtis, J. Gilman, B. Myles, D. Armiger, Jr Capone A., D. Saperstein, B. Stribling, R. Swords, D. H. Orth, T. P. Flood, J. Civantos, S. deBustros, K. H. Packo, P. T. Merrill, C. MacLeod, C. Morrison, D. A. Bryant, D. Doherty, S. Sandoval, J. M. Seddon, M. K. Pinnolis, D. A. Jones-Devonish, C. Evans, N. Davis, C. Callahan, D. Walsh, J. Dubois, I. Burton, N. J. Rosenberg, P. Patel, V. D. Crouse, K. K. Snow, E. Y. Chew, F. L. Ferris, K. Csaky, K. Hall Dabas, L. Goodman, Y. J. Kim, R. Mercer, P. F. Ciatto, E. Kuehl, I. Kivitz, D. Koutsandreas, R. Nashwinter, M. Haughey, G. Babilonia-Ayukawa, A. La-Reau, S. A. McCarthy, L. M. Ayres, P. Lopez, A. Randall, T. R. Friberg, A. Eller, M. B. Gorin, J. Alexander, B. Mack, M. K. Paine, P. S. Corbin

Research output: Contribution to journalArticle

183 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)167-175
Number of pages9
JournalAmerican Journal of Ophthalmology
Volume131
Issue number2
DOIs
StatePublished - 2001
Externally publishedYes

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Eye Diseases
Cataract
Lenses
Reading
Cohort Studies
Clinical Trials
Costs and Cost Analysis

ASJC Scopus subject areas

  • Ophthalmology

Cite this

The Age-Related Eye Disease Study (AREDS) system for classifying cataracts from photographs : AREDS Report No. 4. / Kassoff, A.; Kassoff, J.; Mehu, M.; Buehler, J. A.; Eglow, M.; Kaufman, F.; Kieval, S.; Margherio, R. R.; Cox, M. S.; Garretson, B.; Hassan, T.; Ruby, A.; Trese, M. T.; Werner, J. C.; Williams, G. A.; Regan, V.; Manatrey, P.; Cumming, K.; Lewis, B.; Zajechowski, M.; Falk, R.; Streasick, P.; Szydlowski, L.; McIver, F.; Bridges, C.; Stanley, C.; Klein, Michael; Robertson, Joseph; Wilson, David; Beardsley, C.; Smith, G.; Howard, S.; Dreyer, R. F.; Ma, C.; Chenoweth, R. G.; Zilis, J. D.; Crider, H.; Parker, S.; Martin, D.; Aaberg T.M., Jr; Sternberg P., Jr; Curtis, L.; Gilman, J.; Myles, B.; Armiger, D.; Capone A., Jr; Saperstein, D.; Stribling, B.; Swords, R.; Orth, D. H.; Flood, T. P.; Civantos, J.; deBustros, S.; Packo, K. H.; Merrill, P. T.; MacLeod, C.; Morrison, C.; Bryant, D. A.; Doherty, D.; Sandoval, S.; Seddon, J. M.; Pinnolis, M. K.; Jones-Devonish, D. A.; Evans, C.; Davis, N.; Callahan, C.; Walsh, D.; Dubois, J.; Burton, I.; Rosenberg, N. J.; Patel, P.; Crouse, V. D.; Snow, K. K.; Chew, E. Y.; Ferris, F. L.; Csaky, K.; Hall Dabas, K.; Goodman, L.; Kim, Y. J.; Mercer, R.; Ciatto, P. F.; Kuehl, E.; Kivitz, I.; Koutsandreas, D.; Nashwinter, R.; Haughey, M.; Babilonia-Ayukawa, G.; La-Reau, A.; McCarthy, S. A.; Ayres, L. M.; Lopez, P.; Randall, A.; Friberg, T. R.; Eller, A.; Gorin, M. B.; Alexander, J.; Mack, B.; Paine, M. K.; Corbin, P. S.

In: American Journal of Ophthalmology, Vol. 131, No. 2, 2001, p. 167-175.

Research output: Contribution to journalArticle

Kassoff, A, Kassoff, J, Mehu, M, Buehler, JA, Eglow, M, Kaufman, F, Kieval, S, Margherio, RR, Cox, MS, Garretson, B, Hassan, T, Ruby, A, Trese, MT, Werner, JC, Williams, GA, Regan, V, Manatrey, P, Cumming, K, Lewis, B, Zajechowski, M, Falk, R, Streasick, P, Szydlowski, L, McIver, F, Bridges, C, Stanley, C, Klein, M, Robertson, J, Wilson, D, Beardsley, C, Smith, G, Howard, S, Dreyer, RF, Ma, C, Chenoweth, RG, Zilis, JD, Crider, H, Parker, S, Martin, D, Aaberg T.M., J, Sternberg P., J, Curtis, L, Gilman, J, Myles, B, Armiger, D, Capone A., J, Saperstein, D, Stribling, B, Swords, R, Orth, DH, Flood, TP, Civantos, J, deBustros, S, Packo, KH, Merrill, PT, MacLeod, C, Morrison, C, Bryant, DA, Doherty, D, Sandoval, S, Seddon, JM, Pinnolis, MK, Jones-Devonish, DA, Evans, C, Davis, N, Callahan, C, Walsh, D, Dubois, J, Burton, I, Rosenberg, NJ, Patel, P, Crouse, VD, Snow, KK, Chew, EY, Ferris, FL, Csaky, K, Hall Dabas, K, Goodman, L, Kim, YJ, Mercer, R, Ciatto, PF, Kuehl, E, Kivitz, I, Koutsandreas, D, Nashwinter, R, Haughey, M, Babilonia-Ayukawa, G, La-Reau, A, McCarthy, SA, Ayres, LM, Lopez, P, Randall, A, Friberg, TR, Eller, A, Gorin, MB, Alexander, J, Mack, B, Paine, MK & Corbin, PS 2001, 'The Age-Related Eye Disease Study (AREDS) system for classifying cataracts from photographs: AREDS Report No. 4', American Journal of Ophthalmology, vol. 131, no. 2, pp. 167-175. https://doi.org/10.1016/S0002-9394(00)00732-7
Kassoff, A. ; Kassoff, J. ; Mehu, M. ; Buehler, J. A. ; Eglow, M. ; Kaufman, F. ; Kieval, S. ; Margherio, R. R. ; Cox, M. S. ; Garretson, B. ; Hassan, T. ; Ruby, A. ; Trese, M. T. ; Werner, J. C. ; Williams, G. A. ; Regan, V. ; Manatrey, P. ; Cumming, K. ; Lewis, B. ; Zajechowski, M. ; Falk, R. ; Streasick, P. ; Szydlowski, L. ; McIver, F. ; Bridges, C. ; Stanley, C. ; Klein, Michael ; Robertson, Joseph ; Wilson, David ; Beardsley, C. ; Smith, G. ; Howard, S. ; Dreyer, R. F. ; Ma, C. ; Chenoweth, R. G. ; Zilis, J. D. ; Crider, H. ; Parker, S. ; Martin, D. ; Aaberg T.M., Jr ; Sternberg P., Jr ; Curtis, L. ; Gilman, J. ; Myles, B. ; Armiger, D. ; Capone A., Jr ; Saperstein, D. ; Stribling, B. ; Swords, R. ; Orth, D. H. ; Flood, T. P. ; Civantos, J. ; deBustros, S. ; Packo, K. H. ; Merrill, P. T. ; MacLeod, C. ; Morrison, C. ; Bryant, D. A. ; Doherty, D. ; Sandoval, S. ; Seddon, J. M. ; Pinnolis, M. K. ; Jones-Devonish, D. A. ; Evans, C. ; Davis, N. ; Callahan, C. ; Walsh, D. ; Dubois, J. ; Burton, I. ; Rosenberg, N. J. ; Patel, P. ; Crouse, V. D. ; Snow, K. K. ; Chew, E. Y. ; Ferris, F. L. ; Csaky, K. ; Hall Dabas, K. ; Goodman, L. ; Kim, Y. J. ; Mercer, R. ; Ciatto, P. F. ; Kuehl, E. ; Kivitz, I. ; Koutsandreas, D. ; Nashwinter, R. ; Haughey, M. ; Babilonia-Ayukawa, G. ; La-Reau, A. ; McCarthy, S. A. ; Ayres, L. M. ; Lopez, P. ; Randall, A. ; Friberg, T. R. ; Eller, A. ; Gorin, M. B. ; Alexander, J. ; Mack, B. ; Paine, M. K. ; Corbin, P. S. / The Age-Related Eye Disease Study (AREDS) system for classifying cataracts from photographs : AREDS Report No. 4. In: American Journal of Ophthalmology. 2001 ; Vol. 131, No. 2. pp. 167-175.
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abstract = "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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TY - JOUR

T1 - The Age-Related Eye Disease Study (AREDS) system for classifying cataracts from photographs

T2 - AREDS Report No. 4

AU - Kassoff, A.

AU - Kassoff, J.

AU - Mehu, M.

AU - Buehler, J. A.

AU - Eglow, M.

AU - Kaufman, F.

AU - Kieval, S.

AU - Margherio, R. R.

AU - Cox, M. S.

AU - Garretson, B.

AU - Hassan, T.

AU - Ruby, A.

AU - Trese, M. T.

AU - Werner, J. C.

AU - Williams, G. A.

AU - Regan, V.

AU - Manatrey, P.

AU - Cumming, K.

AU - Lewis, B.

AU - Zajechowski, M.

AU - Falk, R.

AU - Streasick, P.

AU - Szydlowski, L.

AU - McIver, F.

AU - Bridges, C.

AU - Stanley, C.

AU - Klein, Michael

AU - Robertson, Joseph

AU - Wilson, David

AU - Beardsley, C.

AU - Smith, G.

AU - Howard, S.

AU - Dreyer, R. F.

AU - Ma, C.

AU - Chenoweth, R. G.

AU - Zilis, J. D.

AU - Crider, H.

AU - Parker, S.

AU - Martin, D.

AU - Aaberg T.M., Jr

AU - Sternberg P., Jr

AU - Curtis, L.

AU - Gilman, J.

AU - Myles, B.

AU - Armiger, D.

AU - Capone A., Jr

AU - Saperstein, D.

AU - Stribling, B.

AU - Swords, R.

AU - Orth, D. H.

AU - Flood, T. P.

AU - Civantos, J.

AU - deBustros, S.

AU - Packo, K. H.

AU - Merrill, P. T.

AU - MacLeod, C.

AU - Morrison, C.

AU - Bryant, D. A.

AU - Doherty, D.

AU - Sandoval, S.

AU - Seddon, J. M.

AU - Pinnolis, M. K.

AU - Jones-Devonish, D. A.

AU - Evans, C.

AU - Davis, N.

AU - Callahan, C.

AU - Walsh, D.

AU - Dubois, J.

AU - Burton, I.

AU - Rosenberg, N. J.

AU - Patel, P.

AU - Crouse, V. D.

AU - Snow, K. K.

AU - Chew, E. Y.

AU - Ferris, F. L.

AU - Csaky, K.

AU - Hall Dabas, K.

AU - Goodman, L.

AU - Kim, Y. J.

AU - Mercer, R.

AU - Ciatto, P. F.

AU - Kuehl, E.

AU - Kivitz, I.

AU - Koutsandreas, D.

AU - Nashwinter, R.

AU - Haughey, M.

AU - Babilonia-Ayukawa, G.

AU - La-Reau, A.

AU - McCarthy, S. A.

AU - Ayres, L. M.

AU - Lopez, P.

AU - Randall, A.

AU - Friberg, T. R.

AU - Eller, A.

AU - Gorin, M. B.

AU - Alexander, J.

AU - Mack, B.

AU - Paine, M. K.

AU - Corbin, P. S.

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

VL - 131

SP - 167

EP - 175

JO - American Journal of Ophthalmology

JF - American Journal of Ophthalmology

SN - 0002-9394

IS - 2

ER -