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AimTo assess the value of the modified international classification system in screening high-risk patients with bilateral age-related maculopathy (ARM) from those with lower risk characteristics.MethodsIn total, 164 digital images of 106 patients with either bilateral ARM (group A) or the fellow eyes of unilateral exudative age-related macular degeneration (AMD) (Group B) were included. Patients with no signs of ARM in both eyes or those with bilateral late AMD were excluded. The images were randomised and then graded by two masked ophthalmologists based on the modified International Classification of ARM.ResultsThe interobserver consistency between the two graders was high with a Kappa value of 0.82 (SE 0.34, P<0.0001). There were no significant differences in the distribution of the stages of ARM between the two subgroups. Stage 3 was the most common stage in each group for both graders followed by stage 2a in the bilateral drusen group. Stages 1a, 2a and 2b were equally the next common stage in the fellow eye of chordial neovascularisation group.ConclusionA screening system based on clinical characteristics would be of value in risk prediction in a clinical setting. Type of Drusen alone, as identified by the modified International grading system, may not be reliably predictive in screening for patients who are at high risk of developing choroidal neovascularisation.Eye (2006) 20, 199–202. doi:10.1038/sj.eye.6701852; Published online 4 March 2005 [ABSTRACT FROM AUTHOR]

Aims: To assess the portability and dinical applicability of a software program based on Photoshop (Mobe Systems mc, San Jose, CA, USA) ior digital drusen quantification. Methods: Independent graders from the Digital Fundus Photo Reading Center of Columbia University and King's College Hospital used macular background levelling software to quantify the percentage of drusen in the central and middle Wisconsin subfields. 100 images of consecutive patients with choroidal neovascukirisation' in one eye and significant drusen in the other eye were analysed to determine suitability, and 10 were chosen for assessment by this software. Results: Of the 10 images used in the interinstitutional volklation, the random eFfects ANOVA for the central and middle subflelds showed a high degree of interobserver agreement. The ICC for interobsens'. relibility was 023 (95% CI: 67 to 95) f&rihi central subfield and 0.84(95% Cl: 69 to 99) for the middle subfield. Overall agreement with the manuagrading results was - arid the within patient coefficient of variation was about 20% for all the poirwise comparisons between observers and the manual stereo gradings. Of the 100 images used to assess practical applicability of the software, 79 were suid,le for serniouto-, mated analysis. 13 had extensive mixed retinal pigment epithelial (REt) changes limiting drusen identification, five had a significant number of reticular drusen, which are poorly identified by the, software, and three had multiph' small areas of RPE atrophy, which are difficult to distinguish from drusen. CondusionE The software was successfully used by two institutions demonstrating portability, ` with good correlation between graders and to the manual stereo grading. Digital drusen quantification was possible in 79% of the images analysed. [ABSTRACT FROM AUTHOR]

AIMS:To analyse the results of contact trans-scleral cyclodiode photocoagulation (TSCPC) in reducing intraocular pressures (IOP) refractory to medical treatment in a group of patients with intravitreal silicone oil. METHODS:The medical records of 18 patients who received TSCPC were evaluated retrospectively. Success was evaluated primarily in terms of IOP control. Success was defined as a final IOP of less than 22?mmHg RESULTS:In all, 18 eyes of 18 patients were followed up for an average of 21.8 months (range 6-36) (SD=8.6). The mean pre-treatment IOP was 39.6?mmHg (range 25-56?mmHg) (SD=9.3). This reduced to 20.0?mmHg (range 0-48, SD=13.5) after TSCPC, producing a mean reduction of 49%from mean pretreatment IOP levels. The overall success rate was 44%(eight eyes). Chronic hypotony occurred in two patients. IOP remained above that required to meet the IOP reduction criteria in eight patients. CONCLUSION:Our results raise doubts about the efficacy of TSCPC in the management of glaucoma in eyes retaining silicone oil. This may relate to the long duration of silicone oil in our patients. Further studies are required to identify risk factors for treatment failure.Eye (2005) 19, 253-257. doi:10.1038/sj.eye.6701492 Published online 23 July 2004 [ABSTRACT FROM AUTHOR]