Oliver J A C, Cottrell B C, Newton J R, Mellersh C S
Centre for Preventive Medicine, Animal Health Trust, Lanwades Park, Kentford, Newmarket, Suffolk, CB8 7UU, UK.
Animal Eye Limited, 109 North End, Royston, Hertfordshire, SG8 6NX, UK.
J Small Anim Pract. 2017 Nov;58(11):652-658. doi: 10.1111/jsap.12727. Epub 2017 Sep 4.
To investigate inter-examiner variability in gonioscopic evaluation of pectinate ligament abnormality in dogs and to assess level of inter-examiner agreement for four different gonioscopy grading schemes.
Two examiners performed gonioscopy in 98 eyes of 49 Welsh springer spaniel dogs and estimated the percentage circumference of iridocorneal angle affected by pectinate ligament abnormality to the nearest 5%. Percentage scores assigned to each eye by the two examiners were compared. Inter-examiner agreement was assessed following assignment of the percentage scores to each of four grading schemes by Cohen's kappa statistic.
There was a strong positive correlation between the results of the two examiners (R=0·91). In general, Examiner 1 scored individual eyes higher than Examiner 2, especially for eyes in which both examiners diagnosed pectinate ligament abnormality. A "good" level of agreement could only be achieved with a gonioscopy grading scheme of no more than three categories and with a relatively large intermediate bandwidth (κ=0·68).
A three-tiered grading scheme might represent an improvement on hereditary eye disease schemes which simply classify dogs to be either "affected" or "unaffected" for pectinate ligament abnormality. However, the large intermediate bandwidth of this scheme would only allow for the additional detection of those dogs with marked progression of pectinate ligament abnormality which would be considered most at risk of primary closed-angle glaucoma.
研究犬梳状韧带异常的前房角镜评估中检查者间的变异性，并评估四种不同前房角镜分级方案的检查者间一致性水平。
两名检查者对49只威尔士跳猎犬的98只眼睛进行前房角镜检查，并估计受梳状韧带异常影响的虹膜角膜角的圆周百分比，精确到最接近的5%。比较两名检查者给每只眼睛分配的百分比分数。在将百分比分数分配到四种分级方案中的每一种之后，通过Cohen's kappa统计量评估检查者间的一致性。
两名检查者的结果之间存在强正相关（R = 0.91）。一般来说，检查者1对单只眼睛的评分高于检查者2，尤其是在两名检查者都诊断出梳状韧带异常的眼睛中。只有采用不超过三类且中间带宽相对较大的前房角镜分级方案才能达到“良好”的一致性水平（κ = 0.68）。
对于梳状韧带异常，三层分级方案可能是对遗传性眼病方案的一种改进，遗传性眼病方案只是简单地将犬分为“患病”或“未患病”。然而，该方案较大的中间带宽仅允许额外检测那些梳状韧带异常有明显进展的犬，这些犬被认为是原发性闭角型青光眼风险最高的。
