Agreement between image grading of conventional (45°) and ultra wide-angle (200°) digital images in the macula in the Reykjavik eye study

Purpose To establish the agreement between image grading of conventional (45 degrees) and ultra wide-angle (200 degrees) digital images in the macula. Methods In 2008, the 12-year follow-up was conducted on 573 participants of the Reykjavik Eye Study. This study included the use of the Optos P200C AF ultra wide-angle laser scanning ophthalmoscope alongside Zeiss FF 450 conventional digital fundus camera on 121 eyes with or without age-related macular degeneration using the International Classification System. Of these eyes, detailed grading was carried out on five cases each with hard drusen, geographic atrophy and chorioretinal neovascularisation, and six cases of soft drusen. Exact agreement and kappa-statistics were calculated. Results Comparison of the conventional and ultra wide-angle images in the macula showed an overall 96.43% agreement (kappa = 0.93) with no disagreement at end-stage disease; although in one eye chorioretinal neovascularisation was graded as drusenoid pigment epithelial detachment. Of patients with drusen only, the exact agreement was 96.1%. The detailed grading showed no clinically significant disagreement between the conventional 45 degrees and 200 degrees images. Conclusions On the basis of our results, there is a good agreement between grading conventional and ultra wide-angle images in the macula. Eye (2010) 24, 1568-1575; doi:10.1038/eye.2010.85; published online 4 June 2010