Validity of a new optic disc grading software for use in clinical and epidemiological research

Yih Chung Tham, Carol Y. Cheung, Tien Y. Wong, Mani Baskaran, Jiang Liu, Beng Hai Lee, Fengshou Yin, Damon Wk Wong, Jie Jin Wang, Paul Mitchell, Tin Aung, Ching Yu Cheng

Research output: Journal PublicationArticlepeer-review

6 Citations (Scopus)


Background: To determine the reliability and agreement of a new optic disc grading software program for use in clinical, epidemiological research. Design: Reliability and agreement study. Samples: 328 monoscopic and 85 stereoscopic optic disc images. Methods: Optic disc parameters were measured using a new optic disc grading software (Singapore Optic Disc Assessment) that is based on polynomial curve-fitting algorithm. Two graders independently graded 328 monoscopic images to determine intergrader reliability. One grader regraded the images after 1 month to determine intragrader reliability. In addition, 85 stereo optic disc images were separately selected, and vertical cup-to-disc ratios were measured using both the new software and standardized Wisconsin manual stereo-grading method by the same grader 1 month apart. Intraclass correlation coefficient (ICC) and Bland-Altman plot analyses were performed. Main Outcome Measures: Optic disc parameters. Results: The intragrader and intergrader reliability for optic disc measurements using Singapore Optic Disc Assessment was high (ICC ranging from 0.82 to 0.94). The mean differences (95% limits of agreement) for intergrader vertical cup-to-disc ratio measurements were 0.00 (-0.12 to 0.13) and 0.03 (-0.15 to 0.09), respectively. The vertical cup-to-disc ratio agreement between the software and Wisconsin grading method was extremely close (ICC=0.94). The mean difference (95% limits of agreement) of vertical cup-to-disc ratio measurement between the two methods was 0.03 (-0.09 to 0.16). Conclusions: Intragrader and intergrader reliability using Singapore Optic Disc Assessment was excellent. This software was highly comparable with standardized stereo-grading method. Singapore Optic Disc Assessment is useful for grading digital optic disc images in clinical, population-based studies.

Original languageEnglish
Pages (from-to)842-852
Number of pages11
JournalClinical and Experimental Ophthalmology
Issue number9
Publication statusPublished - Dec 2013
Externally publishedYes


  • Epidemiology
  • Optic disc
  • Optic nerve evaluation

ASJC Scopus subject areas

  • Ophthalmology


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