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      Repeatability, Reproducibility, and Comparability of Subjective and Objective Measurements of Intraocular Forward Scattering in Healthy Subjects

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          Abstract

          Purpose. To assess the repeatability, reproducibility, and comparability of measurements of subjective and objective forward scattering in healthy subjects. Methods. We prospectively examined twenty eyes of 20 healthy volunteers (7 men and 13 women; ages, 28.4 ± 4.1 years). The logarithmic straylight value (log( s)) and the objective scattering index (OSI) were measured with a straylight meter (C-Quant) and a point-spread function meter (OQAS), respectively. Results. The 95% limits of agreement (LoA) between first and second measurements ranged from −0.211 to 0.207 for the C-Quant and from −0.302 to 0.477 for the OQAS. The intraclass correlation coefficients for the repeatability of the log( s) and OSI measurements were 0.815 and 0.926, respectively. The mean difference between examiners was −0.051 ± 0.133 (95% LoA; −0.311 to 0.209) for the C-Quant and 0.080 ± 0.307 (−0.522 to 0.682) for the OQAS. There was a modest, but significant, correlation between the log( s) and the OSI (Spearman correlation coefficient r = 0.498, p = 0.026). Conclusions. The C-Quant and the OQAS provide good repeatability and reproducibility, although the OQAS measurement provides a slightly higher ICC than the C-Quant measurement. The subjective forward scattering may be to some extent expressed in the objective forward scattering in healthy subjects.

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          On the methods and theory of reliability.

          This paper reviews the most frequently used and misused reliability measures appearing in the mental health literature. We illustrate the various types of data sets on which reliability is assessed (i.e., two raters, more than two raters, and varying numbers of raters with dichotomous, polychotomous, and quantitative data). Reliability statistics appropriate for each data format are presented, and their pros and cons illustrated. Inadequancies of some methods are highlighted. The meaning of different levels of reliability obtained with various statistics is discussed. This critique is intended for the reading professional and the investigator who has an occasional need for reliability assessment. Statistical expertise is not required and theoretical material is referenced for the interested reader. Necessary formulas for computations are presented in the appendices. A summary table of some suitable reliability measures is presented.
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            An Objective Scatter Index Based on Double-Pass Retinal Images of a Point Source to Classify Cataracts

            Purpose To propose a new objective scatter index (OSI) based in the analysis of double-pass images of a point source to rank and classify cataract patients. This classification scheme is compared with a current subjective system. Methods We selected a population including a group of normal young eyes as control and patients diagnosed with cataract (grades NO2, NO3 and NO4) according to the Lens Opacities Classification System (LOCS III). For each eye, we recorded double-pass retinal images of a point source. In each patient, we determined an objective scatter index (OSI) as the ratio of the intensity at an eccentric location in the image and the central part. This index provides information on the relevant forward scatter affecting vision. Since the double-pass retinal images are affected by both ocular aberrations and intraocular scattering, an analysis was performed to show the ranges of contributions of aberrations to the OSI. Results We used the OSI values to classify each eye according to the degree of scatter. The young normal eyes of the control group had OSI values below 1, while the OSI for subjects in LOCS grade II were around 1 to 2. The use of the objective index showed some of the weakness of subjective classification schemes. In particular, several subjects initially classified independently as grade NO2 or NO3 had similar OSI values, and in some cases even higher than subjects classified as grade NO4. A new classification scheme based in OSI is proposed. Conclusions We introduced an objective index based in the analysis of double-pass retinal images to classify cataract patients. The method is robust and fully based in objective measurements; i.e., not depending on subjective decisions. This procedure could be used in combination with standard current methods to improve cataract patient surgery scheduling.
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              Repeatability of measurements with a double-pass system.

              To evaluate the repeatability of measurements with a double-pass system. Rothschild Foundation, Paris, France. Eyes were separated into 2 control groups ( 40 years), a post-refractive surgery group, and a cataract group. Measurements were performed using the Optical Quality Analysis System. The main outcome measures were the objective scattering index (OSI), the cutoff frequency of the modulation transfer function (MTF), and the Strehl ratio. The repeatability limit was obtained from the individual standard deviations. Forty-two eyes were evaluated. The mean OSI value was 0.47 +/- 0.11 (SD) in the younger control group, 1.73 +/- 0.26 in the older control group, 1.34 +/- 0.16 in the post-refractive surgery group, and 6.15 +/- 0.50 in the cataract group. The mean cutoff MTF value was 39.44 +/- 3.93 cycles per degree (cpd), 26.07 +/- 3.89 cpd, 28.34 +/- 2.84 cpd, and 13.3 +/- 1.69 cpd, respectively, and the mean Strehl ratio, 0.234 +/- 0.023, 0.146 +/- 0.021, 0.169 +/- 0.023, and 0.098 +/- 0.010, respectively. The repeatability limit for the whole population was 0.841 (33.5%) for the OSI, 8.499 (31.1%) for the cutoff MTF, and 0.051 (31%) for the Strehl ratio. The repeatability limit was good and equivalent for the OSI, the MTF, and the Strehl ratio values. There was a wide interval between the normal and pathologic threshold for OSI measurements, indicating that the reliability of the double-pass device complies with the requirements for quantitative assessment of scattering. No author has a financial or proprietary interest in any material or method mentioned. Copyright 2010 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.
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                Author and article information

                Journal
                Biomed Res Int
                Biomed Res Int
                BMRI
                BioMed Research International
                Hindawi Publishing Corporation
                2314-6133
                2314-6141
                2015
                14 June 2015
                : 2015
                : 925217
                Affiliations
                Department of Ophthalmology, University of Kitasato School of Medicine, Kanagawa 252-0374, Japan
                Author notes

                Academic Editor: Jose Manuel González-Méijome

                Article
                10.1155/2015/925217
                4484563
                26176015
                05707db2-80aa-4ceb-a8ea-8ade71b1b414
                Copyright © 2015 Ayaka Iijima et al.

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 1 March 2015
                : 10 May 2015
                : 7 June 2015
                Categories
                Research Article

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