title: Agreement between clinical estimation and a new quantitative analysis by Photoshop software in fundus and angiographic image variables.
abstract: OBJECTIVE
  To evaluate the validity of a new method for the quantitative analysis of fundus or angiographic images using Photoshop 7.0 (Adobe, USA) software by comparing with clinical evaluation.
  
  
  METHODS
  Four hundred and eighteen fundus and angiographic images of diabetic patients were evaluated by three retina specialists and then by computing using Photoshop 7.0 software. Four variables were selected for comparison: amount of hard exudates (HE) on color pictures, amount of HE on red-free pictures, severity of leakage, and the size of the foveal avascular zone (FAZ).
  
  
  RESULTS
  The coefficient of agreement (Kappa) between the two methods in the amount of HE on color and red-free photographs were 85% (0.69) and 79% (0.59), respectively. The agreement for severity of leakage was 72% (0.46). In the two methods for the evaluation of the FAZ size using the magic and lasso software tools, the agreement was 54% (0.09) and 89% (0.77), respectively. Agreement in the estimation of the FAZ size by the lasso magnetic tool was excellent and was almost as good in the quantification of HE on color and on red-free images.
  
  
  CONCLUSIONS
  Considering the agreement of this new technique for the measurement of variables in fundus images using Photoshop software with the clinical evaluation, this method seems to have sufficient validity to be used for the quantitative analysis of HE, leakage, and FAZ size on the angiograms of diabetic patients.
authors.affiliation: Ophthalmic Research Center, Labbafinejad Medical Center, Shahid Beheshti University, M.C., Pasdaran Avenue, Boostan 9 Street, Tehran, 16666, Iran. arramezani@gmail.com
authors.forename: Alireza
authors.initials: A
authors.lastname: Ramezani
authors.forename: Hamid
authors.initials: H
authors.lastname: Ahmadieh
authors.forename: Mohsen
authors.initials: M
authors.lastname: Azarmina
authors.forename: Masoud
authors.initials: M
authors.lastname: Soheilian
authors.forename: Mohammad H
authors.initials: MH
authors.lastname: Dehghan
authors.forename: Mohammad R
authors.initials: MR
authors.lastname: Mohebbi
mesh_terms: D005451:Fluorescein Angiography; D005654:Fundus Oculi; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D010781:Photography / Q000379:methods*; D012372:ROC Curve; D015203:Reproducibility of Results; D012164:Retinal Diseases / Q000175:diagnosis*; D012171:Retinal Vessels / Q000473:pathology*; D012984:Software