Resident physician concordance in tomographic fluid detection in näive patients with neovascular age-related macular degeneration (AMD)

• Published in: Archivos de la Sociedad Española de Oftalmología (English ed.) 2021-05, Vol.96 (5), p.236-241
• Main Authors: Alberto-Pestano, M.M., Piñero-Cutillas, C., Abreu-González, R.
• Format: Article
• Language: English
• Subjects: Age related macular degeneration; Concordancia interobservador; Degeneración macular asociada a la edad neovascular; Fluid; Fluido; Interobserver agreement; Médicos residentes; Optical coherence tomography (OCT); Resident physicians; Tomografía de coherencia óptica (OCT)
• ISSN: 2173-5794; 2173-5794
• DOI: 10.1016/j.oftale.2020.09.016

To analyze the presence of subretinal fluid (SRF), intraretinal fluid (IRF) and subretinal pigment epithelial fluid (SRPEF) in näive patients with exudative neovascular AMD at baseline and at one year follow-up and treatment, in clinical practice, and perform a concordance analysis between resident physicians. A retrospective analysis of the näive patients who attended our service for 6 months between 2016–2017 by neovascular AMD was performed. Optical coherence tomography (OCT), at baseline and at one year follow-up, were analyzed from independently by two resident doctors, determined the presence or not of SRF, IRF, SRPEF. A retina specialist ophthalmologist intervened in cases where there was no consensus among resident physicians. A descriptive and interobserver concordance analysis was performed. 27 eyes of 24 patients were evaluated, 20.8% being men and 79.16% women, with a mean age of 78.57±8 years. 32.14% of the eyes presented the three types of fluid before the start of treatment and the frequency of the different fluids at the beginning and at the end of the follow-up were respectively: SRF, 82.1% and 50%; IRF, 57.1% and 41.7%, and SRPEF, 67.9% and 79.2%). The Kappa analysis of interobserver concordance in the evaluation of the different fluids at the beginning and at the end of the follow-up were respectively: SRF, 0.88 and 0.67; IRF, 0.86 and 0.91, and SRPEF, 0.65 and 0.78. The presence of SRF, IRF, RPEF in clinical practice, in the debut of neovascular AMD has a similar distribution to that presented in international clinical trials. The agreement between resident physicians is very good for SRF and IRF and good for SRPEF in the debut of the disease and good for SRF and IRF and very good for SRPEF at one year of treatment. Describir la presencia de fluido subretiniano (FSR), fluido intrarretiniano (FIR) y fluido sub-epitelio pigmentario de la retina (FSEPR) en pacientes näive con degeneración macular asociada a la edad (DMAE) neovascular exudativa en el momento basal y al año de seguimiento y tratamiento, en nuestra práctica clínica, y realizar un análisis de concordancia entre médicos residentes. Se realizó un análisis retrospectivo de los pacientes näive que acudieron a nuestro servicio durante 6 meses, entre 2016 y 2017, por DMAE neovascular. Las tomografías de coherencia óptica (OCT), del momento basal y al año de seguimiento, fueron analizadas de forma independiente por dos médicos residentes, determinando la presencia o no de FSR, FIR y