Corectopia grading: A novel classification system

ABSTRACT

Objectives

To present and validate the novel grading system for objective classification of corectopia.

Subjects and Methods

We evaluated 28 eyes of 28 patients with or without corectopia and validated the grading and classification system for corectopia according to three major criteria: (i) direction, (ii) extent, and (iii) alteration of mydriasis. Intraclass correlation coefficient (ICC) and inter-rater agreement between 7 inexperienced and 1 experienced ophthalmologist against a golden standard (GS) were calculated.

Results

The ICC for the 7 inexperienced ophthalmologists regarding the grading of direction and centration of the pupil was 0.83 (95% confidence interval (CI), 0.74 to 0.90; p < .001) and 0.57 (95% CI, 0.43 to 0.72; p < .001), respectively. The inter-rater agreement was the same or almost the same in cases of pupil decentration between the inexperienced, experienced ophthalmologists and the GS (k = 0.82; 95% CI, 0.64–1.00; p < .001). In assessing the direction of pupil displacement, the inter-rater agreement was almost perfect between the inexperienced (k = 0.93; 95% CI, 0.84–1.00; p < .001) and experienced (k = 0.92; 95% CI: 0.82–1.02; p < .001) ophthalmologists and the GS.

Conclusion

The first detailed clinical classification is proposed for objective corectopia grading particularly relevant in documenting and assessing progressive disease. It was confirmed to be acceptable for clinical use by inexperienced and experienced ophthalmologists alike.

KEYWORDS:

• iris
• corectopia
• pupil

Acknowledgments

Part of this paper was presented at the annual meeting of the European Society of Cataract and Refractive Surgery (ESCRS) 2018 Congress in Vienna, Austria.

DISCLOSURE STATEMENT

No author(s) have a financial or proprietary interest in any material or method mentioned.

Correction Statement

This article has been republished with minor changes. These changes do not impact the academic content of the article.