Correlation between Optic Nerve Parameters Obtained Using 3D Nonmydriatic Retinal Camera and Optical Coherence Tomography: Interobserver Agreement on the Disc Damage Likelihood Scale

Purpose. To compare stereometric parameters obtained by three-dimensional (3D) optic disc photography and optical coherence tomography (OCT) and assess interobserver agreement on the disc damage likelihood scale (DDLS). Methods. This retrospective study included 190 eyes from 190 patients classified as normal, glaucoma suspect, or glaucomatous. Residents at different levels of training completed the DDLS for each patient before and after attending a training module. 3D optic disc photography and OCT were performed on each eye, and correlations between the DDLS and various parameters obtained by each device were calculated. Results. We found moderate agreement (weighted kappa value, 0.59 +/- 0.03) between DDLS scores obtained by 3D optic disc photography and the glaucoma specialist. The weighted kappa values for agreement and interobserver concordance increased among residents after the training module. Interobserver concordance was the poorest at DDLS stages 5 and 6. The DDLS scored by the glaucoma specialist had the highest predictability value (0.941). Conclusions. The DDLS obtained by 3D optic disc photography is a useful diagnostic tool for glaucoma. A supervised teaching program increased trainee interobserver agreement on the DDLS. DDLS stages 5 and 6 showed the poorest interobserver agreement, suggesting that caution is required when recording these stages.