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Proceedings Paper

Interobserver and intraobserver repeatability of lipid layer pattern evaluation by two experienced observers
Author(s): Carlos García-Resúa; Hugo Pena-Verdeal; Madalena Lira; Manuel G. Penedo; Maria Jesús Giráldez; Eva Yebra-Pimentel
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Paper Abstract

The lipid layer plays a major role in limiting evaporation of the tear film. Based on interference phenomena, there is a test directed to lipid layer pattern (LLP) evaluation, but is affected by subjective interpretation of the patterns. The aim of this study is to compare the LLP evaluation between two experienced observers on a group of healthy patients. Furthermore, the observers re-evaluated the same images in order to check their individual repeatability. LLP was examined using a Tearscope-plus (Keeler, Windsor, UK) attached to a slit lamp. Tear film was recorded by a Topcon DV-3 digital camera video and LLP images were captured. This yielded 124 LLP images that were categorized (based on Guillon’s schema) by two expert observers in two sessions separated by one month. Interobserver repeatability and intraobserver repeatability between both sessions were studied by using Cohen’s kappa coefficient. Comparing LLP categorization between both observers, Cohen's kappa coefficient was 0.615 and 0.633 for first and second session, respectively. When comparing LLP categorization by the same observer between both sessions, Cohen's kappa coefficient was 0.770 and 0.812 for Observer 1 and Observer 2. These results indicate substantial correlation in all cases [range of 0.61–0.80]. The most frequent misinterpretations were between open and closed meshwork and Wave and closed meshwork patterns. Although substantial correlation was found between categorizations of experienced observers, misinterpretation of the patters may appear even in the same observer. Some misinterpretations between adjacent patterns could be palliated by including intermediate patterns between those categories.

Paper Details

Date Published: 18 November 2013
PDF: 8 pages
Proc. SPIE 8785, 8th Iberoamerican Optics Meeting and 11th Latin American Meeting on Optics, Lasers, and Applications, 8785AE (18 November 2013); doi: 10.1117/12.2030432
Show Author Affiliations
Carlos García-Resúa, Univ. de Santiago de Compostela (Spain)
Hugo Pena-Verdeal, Univ. de Santiago de Compostela (Spain)
Madalena Lira, Univ. do Minho (Portugal)
Manuel G. Penedo, Univ. da Coruña (Spain)
Maria Jesús Giráldez, Univ. de Santiago de Compostela (Spain)
Eva Yebra-Pimentel, Univ. de Santiago de Compostela (Spain)

Published in SPIE Proceedings Vol. 8785:
8th Iberoamerican Optics Meeting and 11th Latin American Meeting on Optics, Lasers, and Applications
Manuel Filipe P. C. Martins Costa, Editor(s)

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