CAN DIFFERENT TYPES OF RETINAL EMBOLI BE RELIABLY DIFFERENTIATED FROMONE ANOTHER - AN INTEROBSERVER AND INTRAOBSERVER AGREEMENT STUDY

Objective: To determine whether ophthalmologists can agree on the qual itative assessment of visible retinal emboli. Design: Inter-and intrao bserver agreement study. Setting: The retina and vitreous subspecialty session at the 1996 Canadian Ophthalmological Society meeting. Subjec ts: A total of 42 observers, of whom 30 were retinal specialists. Outc ome measures: The observers viewed 17 fundus photographs of II patient s with embolic acute retinal artery occlusion and classified the visib le retinal emboli into one of three groups: cholesterol, calcific or o ther, Results: Overall, there was slight agreement for the 17 observat ions (mean kappa = 0.063). The kappa statistic for all cases ranged fr om slight to fair agreement. Slight interobserver agreement for the si x unique photographs was observed (mean kappa = 0.073), Slight intraob server agreement was found for the three photographs that were shown i n different orientations (mean kappa = 0.041) and for the two photogra phs shown with differing magnification (mean kappa = 0.102), Conclusio ns: Overall both intraobserver and interobserver agreement on the qual itative assessment of retinal emboli was poor. With only slight agreem ent on the classification of emboli, systemic evaluation of acute reti nal artery occlusion should not be based on qualitative assessment of retinal emboli.