Meibography: Inter-rater reliability

• Purpose. The tear film lipid layer holds an important role in maintaining the integrity and health of the anterior surface of the eye. The meibomian glands found in eyelids are responsible for producing most of the lipids of the tear film. Dysfunction of the meibomian glands leads to increased evaporation of tears, which may lead to dry eye. Meibography is a method used for assessing the drop out of meibomian glands. The aim of this study was to evaluate the reliability between two different examiners when rating meibography images. Methods. The Sirius 3D scheimpflug camera (C.S.O., Florence, Italy) was used to photograph the everted upper and lower eyelids of the right and left eye of 52 subjects. The grade of meibomian gland loss was subjectively graded using the five-grade Meiboscale (Pult, 2012) and the percentage of gland loss was calculated using Phoenix Meibography software (version 3.0.1.021, bon Optic VertriebsGmbH, Lübeck, Germany). Data was analyzed using MedCalc for Windows (version 16.4.3, MedCalc Software, Ostend, Belgium). Results. The inter-rater reliability for the Meiboscale grade of meibomian gland loss was calculated using weighted Cohen’s kappa (linear weights). The result for all 208 images was Kw = 0.542 (95 % CI 0.454 to 0.630), which indicates a moderate agreement. The inter-rater reliability for the percentage of meibomian gland loss was calculated using intraclass correlation coefficient. The result for all 208 images was ICC = 0.794 (95 % CI 0.737 to 0.839), which indicates a substantial agreement. Conclusions. Imaging is an invaluable tool when managing patients in clinical practice. When performing meibography to evaluate meibomian gland loss, using software to calculate the percentage of gland loss gives a better inter-rater agreement than subjective grading of the images.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Oftalmologi (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Ophthalmology (hsv//eng)

Keyword

Optometry

Optometri

Publication and Content Type

ref (subject category)

kon (subject category)