ArticleJournal of optometry
Comparison of subjective and objective methods to determine the retinal arterio-venous ratio using fundus photography.
Article in Journal of optometry. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 2 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
15 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Performance and limitation of machine learning algorithms for diabetic retinopathy screening and its application in health management: a meta-analysis.Biomedical engineering online · 2025Pooled it
- Performance and Limitation of Machine Learning Algorithms for Diabetic Retinopathy Screening: Meta-analysis.Journal of medical Internet research · 2021Pooled it
- Artificial intelligence-based diagnostic model construction and quantitative analysis of retinal vein occlusion lesions using color fundus photographs.Frontiers in cell and developmental biology · 2026Article
- The Effect of Bariatric Surgery on Microvascular Structure and Function, Peripheral Pressure Waveform and General Cardiovascular Risk: A Longitudinal Study.Journal of clinical medicine · 2023Article
- Retinal Vessel Caliber Measurement Bias in Fundus Images in the Presence of the Central Light Reflex.Translational vision science & technology · 2023Article
- The application of arterio-venous ratio (AVR) cut-off values in clinic to stratify cardiovascular risk in patients.Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians (Optometrists) · 2022Article
- Expressions of Serum lncRNAs in Diabetic Retinopathy - A Potential Diagnostic Tool.Frontiers in endocrinology · 2022Article
- Relationship of Retinal Vessel Caliber with Age-Related Macular Degeneration.Journal of ophthalmology · 2022Article
- MSGANet-RAV: A multiscale guided attention network for artery-vein segmentation and classification from optic disc and retinal images.Journal of optometry · 2022Article
- Relationship between Retinal Microvasculature, Cardiovascular Risk and Silent Brain Infarction in Hypertensive Patients.Diagnostics (Basel, Switzerland) · 2021Article
- Clinically valid conclusions from retinal photographs need the best formulae.Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie · 2021Article
- Article
- Inter-method agreement in retinal blood vessels diameter analysis between Dynamic Vessel Analyzer and optical coherence tomography.Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie · 2017Article
- Precision of Epithelial Defect Measurements.Cornea · 2017Article
- A narrative review of retinal vascular parameters and the applications (Part I): Measuring methods.Brain circulationReview
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeTo assess the inter and intra observer variability of subjective grading of the retinal arterio-venous ratio (AVR) using a visual grading and to compare the subjectively derived grades to an objective method using a semi-automated computer program.
methodsFollowing intraocular pressure and blood pressure measurements all subjects underwent dilated fundus photography. 86 monochromatic retinal images with the optic nerve head centred (52 healthy volunteers) were obtained using a Zeiss FF450+ fundus camera. Arterio-venous ratios (AVR), central retinal artery equivalent (CRAE) and central retinal vein equivalent (CRVE) were calculated on three separate occasions by one single observer semi-automatically using the software VesselMap (ImedosSystems, Jena, Germany). Following the automated grading, three examiners graded the AVR visually on three separate occasions in order to assess their agreement.
resultsReproducibility of the semi-automatic parameters was excellent (ICCs: 0.97 (CRAE); 0.985 (CRVE) and 0.952 (AVR)). However, visual grading of AVR showed inter grader differences as well as discrepancies between subjectively derived and objectively calculated AVR (all p<0.000001).
conclusionGrader education and experience leads to inter-grader differences but more importantly, subjective grading is not capable to pick up subtle differences across healthy individuals and does not represent true AVR when compared with an objective assessment method. Technology advancements mean we no longer rely on opthalmoscopic evaluation but can capture and store fundus images with retinal cameras, enabling us to measure vessel calibre more accurately compared to visual estimation; hence it should be integrated in optometric practise for improved accuracy and reliability of clinical assessments of retinal vessel calibres.
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