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Indian J Ophthalmol. 2019 Jul;67(7):1089-1094. doi: 10.4103/ijo.IJO_1509_18.

Clinical validation of RIA-G, an automated optic nerve head analysis software.

Author information

1
Noble Eye Care; Narayana Superspecialty Hospital, Gurugram, Haryana, India.
2
Division of Ophthalmology, Medanta-The Medicity, Gurugram, Haryana, India.
3
SMS Medical College, Jaipur, Rajasthan, India.
4
Noble Eye Care, Gurugram, Haryana; IClinix-Advanced Eye Centre, New Delhi, India.

Abstract

Purpose:

To clinically validate a new automated glaucoma diagnosis software RIA-G.

Methods:

A double-blinded study was conducted where 229 valid random fundus images were evaluated independently by RIA-G and three expert ophthalmologists. Optic nerve head parameters [vertical and horizontal cup-disc ratio (CDR) and neuroretinal rim (NRR) changes] were quantified. Disc damage likelihood scale (DDLS) staging and presence of glaucoma were noted. The software output was compared with consensus values of ophthalmologists.

Results:

Mean difference between the vertical CDR output by RIA-G and the ophthalmologists was - 0.004 ± 0.1. Good agreement and strong correlation existed between the two [interclass correlation coefficient (ICC) 0.79; r = 0.77, P < 0.005]. Mean difference for horizontal CDR was - 0.07 ± 0.13 with a moderate to strong agreement and correlation (ICC 0.48; r = 0.61, P < 0.05). Experts and RIA-G found a violation of the inferior-superior NRR in 47 and 54 images, respectively (Cohen's kappa = 0.56 ± 0.07). RIA-G accurately detected DDLS in 66.2% cases, while in 93.8% cases, output was within ± 1 stage (ICC 0.51). Sensitivity and specificity of RIA-G to diagnose glaucomatous neuropathy were 82.3% and 91.8%, respectively. Overall agreement between RIA-G and experts for glaucoma diagnosis was good (Cohen's kappa = 0.62 ± 0.07). Overall accuracy of RIA-G to detect glaucomatous neuropathy was 90.3%. A detection error rate of 5% was noted.

Conclusion:

RIA-G showed good agreement with the experts and proved to be a reliable software for detecting glaucomatous optic neuropathy. The ability to quantify optic nerve head parameters from simple fundus photographs will prove particularly useful in glaucoma screening, where no direct patient-doctor contact is established.

KEYWORDS:

Disc damage likelihood scale; RIA-G; fundus photograph; glaucoma; optic nerve head; screening; software

PMID:
31238418
DOI:
10.4103/ijo.IJO_1509_18
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