Validity and agreement of Uveitis experts in interpretation of ocular photographs for diagnosis of behçet Uveitis

PubMedID: 24329561Purpose: To evaluate agreement and estimate sensitivity and specificity of uveitis specialists' interpretation of ocular photographs in diagnosing Behçet uveitis. Methods: Fourteen Turkish uveitis specialists, masked to demographic and clinical features of patients, independently labeled ocular photographs (29 Behçet/30 other diagnoses) as "Behçet uveitis" or "non-Behçet." Level of agreement was evaluated using kappa statistics. Photographs were categorized based on ocular signs captured and performance of observers. Results: Exact agreement with the correct diagnosis was 56-81%. Seven reviewers correctly labeled more than 70% of photographs. Interobserver agreement among those 7 reviewers revealed moderate (?=0.41-0.60) or substantial (?=0.61-0.80) agreement in 76% of pairs. Smooth layered hypopyon, superficial retinal infiltrate with retinal hemorrhages, and branch retinal vein occlusion with vitreous haze were correctly recognized as Behçet uveitis by majority of reviewers. Conclusions: There are ocular signs of Behçet disease that can be considered diagnostic even in the absence of any other clinical information. © 2014 Informa Healthcare USA, Inc.Incorporated Research Institutions for SeismologyIlknur Tugal-Tutkun has received financial support outside the submitted work, including an honorarium from IRIS (Institut de Recherches Internationales Servier) and travel grants from Novartis Turkey and Allergan Turkey. No government or nongovernment funding support has been obtained