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Precision of Epithelial Defect Measurements.

Purak C Parikh1, Nita G Valikodath, Christopher B Estopinal

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Summary

Cornea specialists exhibit good reliability when measuring epithelial defects (EDs) with slit-lamp calipers. However, significant interphysician variability exists, impacting clinical decisions.

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Area of Science:

  • Ophthalmology
  • Corneal Surgery
  • Medical Measurement

Background:

  • Corneal specialists routinely measure epithelial defects (EDs) for patient care.
  • Slit-lamp caliper measurements are prone to interphysician variability.

Purpose of the Study:

  • To assess the variability in epithelial defect (ED) measurements among cornea specialists.
  • To discuss the clinical implications of interphysician variability in ED measurements.

Main Methods:

  • Variably sized EDs were created in 48 pig eyes.
  • Three cornea specialists measured vertical and horizontal ED lengths using slit-lamp microscopy.
  • Interrater reliability was evaluated using intraclass correlation coefficients and a 0.5 mm threshold for clinical significance.

Main Results:

  • Average absolute differences in ED measurements ranged from 0.44 to 0.63 mm.
  • 44%-52% of vertical and 31%-40% of horizontal ED measurements showed differences >0.5 mm between examiners.
  • Intraclass correlation coefficients indicated good reliability (0.84-0.85).

Conclusions:

  • Cornea specialists demonstrate good reliability in measuring epithelial defects (EDs).
  • A notable percentage of cases exhibit clinically significant interexaminer variability, depending on the chosen significance threshold.