Classification Criteria for Acute Posterior Multifocal Placoid Pigment Epitheliopathy - 21/10/21

Doi : 10.1016/j.ajo.2021.03.056

The Standardization of Uveitis Nomenclature (SUN) Working Group^¹
Writing Committee: Douglas A. Jabs, Antoine P. Brezin, Andrew D. Dick, Ralph D. Levinson, Lyndell L. Lim, Peter McCluskey, Neal Oden, Alan G. Palestine, Jennifer E. Thorne, Brett E. Trusko, Albert Vitale, and Susan E. Wittenberg
^{^{2
Affiliations: Members of the SUN Working Group are listed online at AJO.com. From the Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA (D.A.J., J.E.T.); Wilmer Eye Institute, Department of Ophthalmology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA (D.A.J., J.E.T.); Department of Ophthalmology, University of Paris V H..pital Cochin, Paris, France (A.P.B.); Academic Unit of Ophthalmology, Bristol Medical School, University of Bristol, Bristol, United Kingdom (A.D.D.); National Institute for Health Research Biomedical Research Centre at Moorfields Eye Hospital, London, United Kingdom (A.D.D.); University College London Institute of Ophthalmology, London United Kingdom (A.D.D.); UCLA Stein Eye Institute and Department of Ophthalmology, David Geffen School of Medicine at UCLA, Los Angeles, California, USA (R.D.L.); Center for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, Australia (L.L.L); Save Sight Institute, Department of Ophthalmology, University of Sydney School of Medicine, Sydney, New South Wales, Australia (P.M.); The Emmes Company, LLC, Rockville, Maryland, USA (N.O.); Department of Ophthalmology, University of Colorado School of Medicine, Aurora, Colorado, USA (A.G.P.); Department of Medicine, Texas A&M University, College Station, Texas, USA (B.E.T.); Department of Ophthalmology, University of Utah School of Medicine, Salt Lake City, Utah, USA (A.V.); and Houston Eye Associates, Houston, Texas, USA (S.E.W.).}}^{^{3
Conflict of Interest: Douglas A. Jabs: none; Antoine P. Brezin: none; Andrew D. Dick: none; Ralph Levinson: none; Lyndell L. Lim: none; Peter McCluskey: none; Neal Oden: none; Alan G. Palestine: none; Jennifer E. Thorne: Dr Thorne engaged in a portion of this research as a consultant and was compensated for the consulting service; Brett E. Trusko: none; Albert Vitale: none; Susan E. Wittenberg: none. All authors attest that they meet the current ICMJE criteria for authorship.}}^{^{⁎
Inquiries to: Douglas A. Jabs, Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, 615 North Wolfe St, Baltimore, MD 21205, USA}}
Douglas A. Jabs, Antoine P. Brezin, Andrew D. Dick, Ralph D. Levinson, Lyndell L. Lim, Peter McCluskey, Neal Oden, Alan G. Palestine, Jennifer E. Thorne, Brett E. Trusko, Albert Vitale, Susan E. Wittenberg

Résumé

Purpose

To determine classification criteria for acute posterior multifocal placoid pigment epitheliopathy (APMPPE).

Design

Machine learning of cases with APMPPE and 8 other posterior uveitides.

Methods

Cases of posterior uveitides were collected in an informatics-designed preliminary database, and a final database was constructed of cases achieving supermajority agreement on diagnosis, using formal consensus techniques. Cases were split into a training set and a validation set. Machine learning using multinomial logistic regression was used on the training set to determine a parsimonious set of criteria that minimized the misclassification rate among the posterior uveitides. The resulting criteria were evaluated on the validation set.

Results

One thousand sixty-eight cases of posterior uveitides, including 82 cases of APMPPE, were evaluated by machine learning. Key criteria for APMPPE included (1) choroidal lesions with a plaque-like or placoid appearance and (2) characteristic imaging on fluorescein angiography (lesions “block early and stain late diffusely”). Overall accuracy for posterior uveitides was 92.7% in the training set and 98.0% (95% confidence interval 94.3, 99.3) in the validation set. The misclassification rates for APMPPE were 5% in the training set and 0% in the validation set.

Conclusions

The criteria for APMPPE had a low misclassification rate and seemed to perform sufficiently well for use in clinical and translational research.

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Plan

Methods

Informatics

Case Collection and Case Selection

Supplemental Material available at AJO.com.

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Vol 228

P. 174-181 - août 2021 Retour au numéro

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Classification Criteria for Varicella Zoster Virus Anterior Uveitis
The Standardization of Uveitis Nomenclature (SUN) Working Group, Douglas A. Jabs, Nisha R. Acharya, Laure Caspers, Soon-Phaik Chee, Debra Goldstein, Peter McCluskey, Philip I. Murray, Neal Oden, Alan G. Palestine, James T. Rosenbaum, Jennifer E. Thorne, Brett E. Trusko

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Classification Criteria for Syphilitic Uveitis
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Classification Criteria for Acute Posterior Multifocal Placoid Pigment Epitheliopathy - 21/10/21

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