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Purpose:

This study assessed the interobserver and intraobserver grading reliability of the Keith–Wagener–Barker (KWB) system to the proposed Mitchell–Wong ‘simplified’three-grade classification for hypertensive retinopathy.

Methods:

Digital retinal images of normal and hypertensive human fundii (n= 50 per group) were randomly graded by an optometrist and an ophthalmologist using the two systems. Interobserver agreement was compared to a ‘gold standard’research grader. Intraobserver agreement was assessed through a repeat grading after 6 months. Cohen's kappa coefficients were used to assess the degree of agreement.

Results:

Both clinicians demonstrated a good level of agreement with the KWB and simplified classification compared with a ‘gold standard’grader; there was no significant difference in the level of agreement for either of the two classification methods for either observer. The simplified …