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The authors present a novel corectopia classification system using 28 eyes of 28 patients with or without corectopia. The grading and classification system for corectopia was as follows: (i) Direction of decentration: superior (DecS), superonasal (DecSN), nasal (DecN), inferonasal (DecIN), inferior (DecI), inferotemporal (DecIT), temporal (DecT), superotemporal (DecST); (ii) Magnitude of decentration: (Dec) 0 – no corectopia, Dec 1 – the pupil incorporates the corneal centre, Dec 2 – the pupil is entirely outside the corneal centre; (iii) Magnitude of corectopia after pharmacologically induced mydriasis (M): 0 – no corectopia, M 1 – the dilated pupil incorporates the corneal centre, M 2 – the dilated pupil is entirely outside of the corneal centre. If the pupil in its pharmacologically induced mydriasis is located differently from the pupil in its native condition, the direction is added after the M abbreviation (i.e.: MN1). Intraclass correlation coefficient (ICC) and inter-rater agreement between seven inexperienced and one experienced ophthalmologist against a golden standard (GS) were calculated. The ICC for the seven 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 < 0.001) and 0.57 (95% CI, 0.43 to 0.72; p < 0.001), 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 < 0.001). 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 < 0.001) and experienced (k = 0.92; 95% CI: 0.82–1.02; p < 0.001) ophthalmologists and the GS. The authors suggest that this grading scale will be particularly relevant in documenting and assessing progressive disease. From this study they confirmed the system to be acceptable for clinical use by inexperienced and experienced ophthalmologists alike.

Corectopia grading: a novel classification system.
Anisimova N, Arbisser L, Tzamalis A, et al.
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Su Young

Moorfields Eye Hospital NHS Trust, London, UK.

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