Evaluation of fungal keratitis using a newly developed computer program, Optscore, for grading digital corneal photographs.
OBJECTIVE
To validate computer software developed to assess digital corneal photographs of fungal keratitis in clinical research.


METHODS
A cornea specialist and five medical students (after training) graded on two occasions 100 corneal photographs of patients with fungal keratitis using Optscore software. Variables assessed were lesion area, location, degree of opacity, percentage of the ulcer lying within a central 4 mm circle of the cornea. Intraclass correlation coefficients (ICCs) were used to assess intragrader reliability, agreement of the students with the corneal specialist, and the reliability of the group mean of the student raters. The area determined using Optscore was compared to the area estimated from slit lamp and to visual acuity.


RESULTS
As a group, medical students achieved an ICC greater than 0.9 for five out of the seven assessed variables. Similar levels of consistency were found after analyzing the graders' individual results compared to the specialist. The area estimated using slit lamp examination was highly correlated with the mean area determined by Optscore, as was the logarithm of the minimum angle of resolution visual acuity at enrollment.


CONCLUSIONS
Non-expert graders using Optscore to assess digital photographs of fungal keratitis are self-consistent, agree with an expert grader both as a group and individually, and measurements of ulcer area obtained from Optscore are highly correlated with measurements of the same patients obtained on clinical examination. These observations support the validity of Optscore for assessing corneal pathology associated with fungal keratitis and make it a promising clinical research tool.
Department of Surgery (Ophthalmology) and Microbiology, Geisel School of Medicine at Dartmouth , Hanover, NH , USA .
Christine M
CM
Toutain-Kidd
Travis C
TC
Porco
Eric M
EM
Kidd
M
M
Srinivasan
Namperumalsamy V
NV
Prajna
Nisha
N
Acharya
Thomas
T
Lietman
Michael E
ME
Zegans
D003320:Corneal Ulcer / Q000175:diagnosis* / Q000382:microbiology; D003941:Diagnostic Techniques, Ophthalmological; D015821:Eye Infections, Fungal / Q000175:diagnosis*; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D015588:Observer Variation; D010781:Photography / Q000379:methods; D011856:Radiographic Image Enhancement; D012044:Regression Analysis; D015203:Reproducibility of Results; D012984:Software