title: Comparison of color fundus photographs and fundus autofluorescence images in measuring geographic atrophy area.
abstract: OBJECTIVE
  To assess the agreement between color fundus photographs (CFP) and fundus autofluorescence (FAF) images when measuring geographic atrophy (GA) area and reproducibility of measurements between graders. Frequency and disagreement types were also determined.
  
  
  METHODS
  Eyes with GA secondary to age-related macular degeneration had CFP and FAF imaging on the same day. Seventy-two eyes from 72 patients were included in the analysis. Three graders calculated GA area using digital imaging software. Main outcome measures included agreement between graders for GA area on both FAF and CFP and agreement between both imaging modalities.
  
  
  RESULTS
  The intraclass correlation for the 3 graders for FAF images was 0.99 (95% confidence interval, 0.98-0.99). For CFP, it was 0.96 (95% confidence interval, 0.94-0.97). The intraclass correlation between imaging modalities for Graders 1, 2, and 3 were 0.93, 0.85, and 0.87, respectively. Sensitivities to detect involvement of fovea (CFP, 86-97%; FAF, 72-93%) and specificities to detect sparing of fovea (CFP, 74-76%; FAF, 59-88%) overlapped between imaging modalities.
  
  
  CONCLUSIONS
  Both CFP and FAF imaging are reliable for measuring GA area. Interobserver agreement was slightly higher for FAF images. Although the high agreement between modalities suggests that either would be appropriate for measuring GA area, using both may be the best approach for following GA progression.
authors.affiliation: The Duke Center for Macular Diseases and Albert Eye Research Institute, Duke Eye Center, Durham, North Carolina, USA.
authors.forename: Aziz A
authors.initials: AA
authors.lastname: Khanifar
authors.forename: David E
authors.initials: DE
authors.lastname: Lederer
authors.forename: Jason H
authors.initials: JH
authors.lastname: Ghodasra
authors.forename: Sandra S
authors.initials: SS
authors.lastname: Stinnett
authors.forename: Jane J
authors.initials: JJ
authors.lastname: Lee
authors.forename: Scott W
authors.initials: SW
authors.lastname: Cousins
authors.forename: Srilaxmi
authors.initials: S
authors.lastname: Bearelly
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005451:Fluorescein Angiography; D005654:Fundus Oculi; D057092:Geographic Atrophy / Q000175:diagnosis* / Q000209:etiology; D006801:Humans; D008268:Macular Degeneration / Q000150:complications; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D010781:Photography; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity