Halleran,
1 Clare
2 G.
3 T.
5 M.
8 Leslie ;
; Hauswirth, Scott ; Kwan, Justin ; Hom, Milton ; O'Dell, Moy, Schachter, Aubrey7 ; Harthan, Jennifer4 ; Lin, Meng C.10; McNamara, Nancy A.9
6 Allison
;
1. East Coast Eye Care, Clarenville, NL, Canada. 2. Minnesota Eye Consultants, Minneapolis, MN. 3. Marshall B. Ketchum University, Fullerton, CA, 4. Cornea, Illinois College of Optometry, Chicago, IL. 5. Private Practice, Azusa, CA. 6. Clearvue Vision Center, Kent, WA 7. Advanced Eye Care, Pismo Beach, CA 8. Dry Eye centre of Pennsylvania, York, PA 9. University of California SF, San Francisco, CA 10. UC berkeley, Berkeley, CA
Introduction
Presentation Number: 6219- A0147
Figure 1. Meibography images u Meibography changes have been documented in individuals using Isotretinoin (Accutane) medication1
u Several methods of grading meibomian gland structure via meibography exist.
u Un-weighted kappa indicated fair agreement between graders using the Arita Scale (0.23[0.00-0.55]) and an ICC of 0.524[0.10-0.79], p=0.009. Weighted kappa also indicated fair agreement (0.36).
Purpose
u In all 18 images, at least one observer graded some degree of meibomian gland atrophy
Figure 2. Arita Grading Scale
u As meibography becomes more widespread in clinical practice, incorporation of a pictorial scale which is reliable and repeatable is necessary.
u Meibography images from patients who had a history of isotretinoin use were complied. u The lower eyelid images were captured with the Oculus Keratograph 5M and ReSeeVit instruments.
u The Pult and Arita scales were evaluated using Cohen kappa, weighted kappa, and intra-class correlation to determine agreement.
Contact Information
Clare Halleran O.D. –
[email protected]
Conclusions u Isotretinoin has been documented to cause structural changes in meibomian gland architecture visible via meibography1
Methods
u Masked observers graded the provided images using either the Pult or Arita grading scales; the scale each observer used was assigned randomly.
u Eighteen lower lid images were graded by four masked graders. u U n-weighted kappa indicated slight agreement between graders using the Pult scale (0.14[0.00-0.46]) and ICC of 0.733[0.426-0.89], p
