INTEROBSERVER AGREEMENT IN THE EVALUATION OF ACUTE RETINAL ARTERY-OCCLUSION

Objective: To determine the agreement between two ophthalmologists in the evaluation of two important funduscopic features related to acute retinal artery occlusion: retinal cloudy swelling and visible retinal emboli. Design: An interobserver variability study in which two ophtha lmologists (one trained in glaucoma, the other in neuro-ophthalmology) independently viewed fundus photographs and categorized them with res pect to the presence or absence of cloudy swelling and retinal emboli. Inter-and intraobserver agreement was calculated with the kappa stati stic. Setting: Retina service at a university-affiliate hospital in Ki ngston, Ont. Patients: The fundus photographs of 102 patients were inc luded: 60 with acute retinal artery occlusion, 30 with conditions mimi cking acute retinal artery occlusion and 12 healthy patients. Results: Both interobserver and intraobserver agreement as to the presence of retinal cloudy swelling were very high (kappa = 0.835 and 0.866 respec tively). More variability was seen for the presence of retinal emboli, but, overall, interobserver and intraobserver agreement were still hi gh (kappa = 0.726 and 0.629 respectively). Conclusions: Our results su ggest that clinicians use similar visual clues to categorize fundi wit h respect to retinal cloudy swelling and visible retinal emboli.