EVALUATION OF A REFERENCE SET BASED GRADING SYSTEM FOR RETINAL NERVE-FIBER LAYER PHOTOGRAPHS IN 1941 EYES

Purpose: To evaluate a reference set based grading system for retinal nerve fiber laver photographs. Methods: A total of 1,941 retinal nerve fiber layer photographs (Canon nonmydriatic camera) were evaluated us ing a reference grading system. The reference system consists of 25 ph otographs of the retinal nerve fiber layer (Canon CF60U camera) of nor mals and patients with glaucoma, Each reference photograph represents a score for the visibility of the nerve fibers. Superior and inferior regions of the 1,941 photographs of the sample of the normal populatio n mere matched separately to the references. Results: The standard dev iation of between eves differences was 2.76. This standard deviation c ompared reasonably to the standard deviation of 1.0 to 1.9 for real re peated measurements in an earlier study and indicates that the grading system has good accuracy in relation to the total range of 1 to 25. A clear relationship between photograph score and age was established. Conclusion: The photographic grading system demonstrated that it is vi able in a different setting. Therefore, evaluation of retinal nerve fi ber layer photographs with a photographic reference set might help oph thalmologists and technicians to integrate retinal nerve fiber layer p hotography in their clinical practice.