title: Morphologic assessment for glaucoma in the Multicenter Uveitis Steroid Treatment (MUST) trial.
abstract: OBJECTIVE
  To compare Reading Center (RC) cup-to-disc ratio (CDR) assessment from stereoscopic photographs with clinician estimation in a uveitis clinical trial.
  
  
  METHODS
  Clinical estimation of CDR was performed by ophthalmologists via dilated biomicroscopy. Photographic evaluation was performed at an independent RC by masked, certified evaluators. Quality control was performed by repeat grading of 77 randomly selected images.
  
  
  RESULTS
  Among 479 eyes with uveitis, 353 eyes had clinical and photographic grades for CDR. Agreement between clinical and RC grading was fair, with exact agreement of 29%. Agreement within 0.1 and 0.2 CDR was 70 and 93%, respectively (weighted κ = .34). Intergrader reproducibility at the RC was better (weighted κ = .59, ICC 0.74).
  
  
  CONCLUSIONS
  Morphologic assessment of cup to disc ratio is an important outcome and safety measure for determining glaucomatous damage in clinical trials. Masked RC measurements are more likely to be accurate than biomicroscopic grading in identifying meaningful anatomical change associated with glaucoma.
authors.affiliation: Fundus Photograph Reading Center, Department of Ophthalmology and Visual Sciences, University of Wisconsin, Madison, Wisconsin 53717, USA.
authors.forename: Sapna S
authors.initials: SS
authors.lastname: Gangaputra
authors.forename: Michael M
authors.initials: MM
authors.lastname: Altaweel
authors.forename: Qian
authors.initials: Q
authors.lastname: Peng
authors.forename: David S
authors.initials: DS
authors.lastname: Friedman
authors.forename: P Kumar
authors.initials: PK
authors.lastname: Rao
authors.forename: C Stephen
authors.initials: CS
authors.lastname: Foster
authors.forename: Rosa Y
authors.initials: RY
authors.lastname: Kim
authors.forename: Susan B
authors.initials: SB
authors.lastname: Reed
authors.forename: Sunil K
authors.initials: SK
authors.lastname: Srivastava
authors.forename: Ira G
authors.initials: IG
authors.lastname: Wong
authors.forename: John H
authors.initials: JH
authors.lastname: Kempen
mesh_terms: D004343:Drug Implants; D005446:Fluocinolone Acetonide / Q000008:administration & dosage*; D005901:Glaucoma / Q000209:etiology / Q000473:pathology*; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D009898:Optic Disk / Q000473:pathology*; D010781:Photography; D015203:Reproducibility of Results; D014605:Uveitis / Q000150:complications / Q000188:drug therapy* / Q000473:pathology*
chemical_list: D004343:Drug Implants; D005938:Glucocorticoids; D005446:Fluocinolone Acetonide