International photographic classification and grading system for myopic maculopathy.

Area of Science:

• Ophthalmology
• Retinal Diseases
• Medical Imaging

Background:

• High myopia is associated with various retinal degenerative lesions.
• Accurate classification of myopic maculopathy is crucial for research and clinical practice.
• Existing classification systems may lack standardization.

Purpose of the Study:

• To develop and evaluate a reproducible classification and grading system for myopic maculopathy.
• To standardize the assessment of myopic macular lesions.

Main Methods:

• Literature review and consensus meetings defined myopic macular lesions.
• A modified Delphi process and consensus formulated the classification system.
• Reproducibility was assessed using inter- and intraobserver agreement and kappa statistics on 100 retinal photographs.

Main Results:

• A 5-category system (0-4) for myopic maculopathy was established, ranging from no lesions to macular atrophy.
• "Plus" lesions (lacquer cracks, choroidal neovascularization, Fuchs spot) and posterior staphyloma were defined.
• High intraobserver agreement (≥85%, kappa ≥0.6) and satisfactory interobserver agreement (kappa ≥0.4) were achieved.

Conclusions:

• A reproducible classification system for myopic maculopathy has been proposed.
• This system facilitates standardized communication and comparison in clinical trials and epidemiological studies.
• Uniform classification improves the reliability of myopia research findings.