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Agreement on the evaluation of glaucomatous optic nerve head findings by ophthalmology residents and a glaucoma specialist

Authors Rossetto JD, Melo LA Jr, Campos MS, Tavares IM

Received 22 April 2017

Accepted for publication 17 June 2017

Published 10 July 2017 Volume 2017:11 Pages 1281—1284


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Dr Scott Fraser

Julia D Rossetto, Luiz Alberto S Melo Jr, Mauro S Campos, Ivan M Tavares

Department of Ophthalmology and Visual Sciences, Paulista School of Medicine, Universidade Federal de São Paulo, Sao Paulo, Brazil

Objectives: To assess agreement among ophthalmology residents and a glaucoma expert in the evaluation of cross-sectional glaucomatous optic nerve head characteristics using stereoscopic photographs.
Methods: Twenty stereo photographs were analyzed by ophthalmology residents just after completion of their first (First-Year Group) or third (Third-Year Group) year of residency and by a glaucoma expert. The agreement was assessed using the kappa statistic (κ) and limits of agreement.
Results: Agreement among resident groups and the expert ranged from poor to moderate. Agreement between Third Years and the expert seems to be better than that between First Years and the expert, especially in the evaluation of “nasal cupping”, “barring circumlinear vessel,” “notching”, and “retinal nerve fiber layer defect” criteria. However, no improvement was seen in the agreement with the expert regarding glaucomatous optic neuropathy, which was 64% (κ=0.19) for First Years and 63% (κ=0.20) for Third Years.
Conclusion: Agreement between residents and the expert was poor to moderate and similar when comparing both groups. This may suggest that the residents learn how to identify glaucoma signals during the first year of training, and the results of this study may facilitate the creation of targeted teaching tools in residency training.

Keywords: optic disk, residency and internship, medical education, glaucoma

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