Validity of a new computer-aided diagnosis imaging program to quantify nuclear cataract from slit-lamp photographs.
OBJECTIVE
To validate a new computer-aided diagnosis (CAD) imaging program for the assessment of nuclear lens opacity.


METHODS
Slit-lamp lens photographs from the Singapore Malay Eye Study (SiMES) were graded using both the CAD imaging program and manual assessment method by a trained grader using the Wisconsin Cataract Grading System. Cataract was separately assessed clinically during the study using Lens Opacities Classification System III (LOCS III). The repeatability of CAD and Wisconsin grading methods were assessed using 160 paired images. The agreement between the CAD and Wisconsin grading methods, and the correlations of CAD with Wisconsin and LOCS III were assessed using the SiMES sample (5547 eyes from 2951 subjects).


RESULTS
In assessing the repeatability, the coefficient of variation (CoV) was 8.10% (95% confidence interval [CI], 7.21-8.99), and the intraclass correlation coefficient (ICC) was 0.96 (95% CI, 0.93-0.96) for the CAD method. There was high agreement between the CAD and Wisconsin methods, with a mean difference (CAD minus Wisconsin) of -0.02 (95% limit of agreement, -0.91 and 0.87) and an ICC of 0.81 (95% CI, 0.80-0.82). CAD parameters were also significantly correlated with LOCS III grading (all P < 0.001).


CONCLUSIONS
This new CAD imaging program assesses nuclear lens opacity with results comparable to the manual grading using the Wisconsin System. This study shows that an automated, precise, and quantitative assessment of nuclear cataract is possible.
Singapore Eye Research Institute, Singapore.
Carol Yim-lui
CY
Cheung
Huiqi
H
Li
Ecosse L
EL
Lamoureux
Paul
P
Mitchell
Jie Jin
JJ
Wang
Ava Grace
AG
Tan
Lily K
LK
Johari
Jiang
J
Liu
Joo Hwee
JH
Lim
Tin
T
Aung
Tien Yin
TY
Wong
D019540:Area Under Curve; D002386:Cataract / Q000145:classification / Q000175:diagnosis*; D003936:Diagnosis, Computer-Assisted; D003952:Diagnostic Imaging / Q000379:methods*; D003941:Diagnostic Techniques, Ophthalmological; D005260:Female; D006801:Humans; D007907:Lens Nucleus, Crystalline / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D010781:Photography; D015203:Reproducibility of Results