Subjective interpretation of Scheimpflug tomography maps of eyes with Fuchs’ endothelial corneal dystrophy (FECD) is highly repeatable for disease classification, a recent study suggests.

This randomized reliability analysis evaluated Scheimpflug pachymetry and posterior elevation maps of corneas ranging in disease severity for the presence of edema. A team assessed agreement between interpretations of images taken within minutes on the same day, images taken at a similar time on a different day and images taken over the course of a morning.

The researchers discovered that at least 88% of interpretations of images taken within minutes on the same day were in agreement for individual tomographic features, while less than 4% were in complete disagreement. As for interpretations of images taken at a similar time on a different day, they noted that at least 77% were in agreement and complete disagreement did not occur. They added that interpretations agreed for at least 81% of images taken over the course of a morning and were in complete disagreement in less than 7% of images. The investigators found that both intra- and inter- observer agreement was ≥93%, avoiding complete disagreement altogether.

“Although small variations in interpretations resulted from pathophysiologic changes in corneal hydration and other factors, clinically significant disagreements in interpretation were uncommon and, therefore, unlikely to affect clinical decision-making,” the study authors concluded in their paper.

Patel SV, Hodge DO, Treichel EJ, et al. Repeatability of Scheimpflug tomography for assessing Fuchs endothelial corneal dystrophy. Am J Ophthalmol. February 27, 2020. [Epub ahead of print].