Inter-Rater Reliability of Cyclotorsion Measurements Using Fundus Photography

Abstract

Background The foveo-papillary angle (FPA) on fundus photographs is the accepted standard for the measurement of ocular cyclotorsion. We assessed the inter-rater reliability of this method in healthy subjects and in patients with trochlear nerve palsies.

Patients and Methods In this methodological study, fundus photographs of healthy subjects and of patients with trochlear nerve palsies were made with a fundus camera (Zeiss Fundus Camera FF 450 plus, Jena, Germany). Three independent observers measured the FPA on the fundus photographs of all subjects in synedra View (synedra View 16, Version 16.0.0.11, Innsbruck, Austria).

Results One hundred and four eyes of 52 subjects (26 healthy controls and 26 patients) were assessed. The mean FPA of the healthy controls was 5.80 degrees (°) [± 0.44 standard error of the mean (SEM)] compared to 11.55° (± 0.80 SEM) for patients with trochlear nerve palsies. The inter-rater reliability of all measured FPAs showed an intraclass correlation coefficient (ICC) of 0.98 (95% CI 0.97 – 0.98).

Conclusions The inter-rater reliability of objective cyclotorsion measurements using fundus photographs was very high.

Zusammenfassung

Hintergrund Der foveopapilläre Winkel auf Fundusfotografien dient bisher als Standard zur Bestimmung der objektiven okulären Zyklorotation. Das Ziel der Studie ist, die Interrater-Reliabilität der Zyklorotation bei gesunden Personen wie auch bei Patienten mit Trochlearisparese anhand der Fundusfotografien zu messen.

Patienten und Methoden Fundusfotografien von Probanden wie auch von Patienten mit Trochlearisparese wurden mit einer Funduskamera (Zeiss Fundus Camera FF 450 plus, Jena, Deutschland) aufgenommen. Drei unabhängige Personen haben den foveopapillären Winkel anhand der Fundusfotografien in synedra View (synedra View 16, Version 16.0.0.11, Innsbruck, Österreich) gemessen.

Ergebnisse Es wurden 104 Augen von 52 Personen untersucht (26 Probanden, 26 Patienten). Bei den Probanden betrug der foveopapilläre Winkel durchschnittlich 5,8° (± 0,44 Standard Error of the Mean [SEM]), bei den Patienten mit Trochlearisparese 11,55° (± 0,80 SEM). Die Interrater-Reliabilität der gemessenen foveopapillären Winkel zeigte einen Intraclass Correlation Coefficient (ICC) von 0,98 (95%-KI 0,97 – 0,98).

Schlussfolgerung Die objektive Zyklorotationsmessung anhand von Fundusfotografien zeigte eine hohe Interrater-Reliabilität zwischen verschiedenen Untersuchern.

Key words

cyclotorsion - fundus photography - ocular torsion - trochlear nerve palsy - foveo-papillary angle - disc-fovea angle

Schlüsselwörter

Trochlearisparese - foveopapillärer Winkel - Fundusfotografie - Zyklorotation - okuläre Torsion

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