ArticleEye (London, England)2023
Inter-observer agreement in grading severity of diabetic retinopathy in wide-field fundus photographs.
Article in Eye (London, England), 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- Rethinking scale in ophthalmic artificial intelligence: from bigger models to smarter clinical reasoning.NPJ digital medicine · 2026Review
- Real-world performance of the AI diagnostic system IDx-DR in the diagnosis of diabetic retinopathy and its main confounders.Scientific reports · 2026Article
- Comprehensive Review of Open-Source Fundus Image Databases for Diabetic Retinopathy Diagnosis.Sensors (Basel, Switzerland) · 2025Review
- Investigations on whether image-sharpening algorithm can improve the determination of severity of diabetic retinopathy in ultra-widefield fundus photographs.Scientific reports · 2025Observational
- The novel antidiabetic medications on diabetic retinopathy: relevant molecular mechanisms, advancing diagnostic innovations, and therapeutic implications.Frontiers in medicine · 2025Review
- Modern Approach to Diabetic Retinopathy Diagnostics.Diagnostics (Basel, Switzerland) · 2024Review
Corrections and comments
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Authors and funding
11 authors.
Funding
Abstract
objectiveTo examine the inter-observer agreement between two retina specialists in grading diabetic retinopathy (DR) severity in ultra-wide-field fundus photographs.
methodsTwo hundred and seventy patients with diabetes, who visited the vitreoretinal specialty at a tertiary eye care hospital, with or without DR underwent comprehensive ophthalmic examination, dilated retinal exam and Optos ultra-wide-field (UWF) retinal photography. Optos images were graded for DR severity based on the International Clinical Diabetic Retinopathy Disease Severity Scale by two retina specialists with same number of years of experience, masked to the clinical details of the participants.
resultsThe two graders showed agreement in 229/270 images (84.8%) and disagreement in 41/270 images (15.2%). The unweighted kappa for agreement between graders was k = 0.715, SE = 0.037 and the weighted kappa was k = 0.838, SE = 0.022. No DR was identified in 170/270 (62.9%) patients, mild NPDR in 15/270 (5.6%) patients, moderate NPDR in 35/270 (12.9%) patients, severe NPDR in 4/270 (1.48%) patient and PDR in 5/270 (1.85%) patients by both graders. Disagreement was neither related to the learning curve of graders nor with the patient's age (p = 0.574), gender (p = 0.169), duration of diabetes (0.660) or the lens being phakic or pseudophakic (p = 0.171) on logistic regression.
conclusionsThe impact of disagreement noted between observers in grading DR on UWF fundus photographs should be considered when utilizing UWF system in clinical studies.
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