Objectives: We aimed to establish the degree of consensus among clinicians on descriptors of KP morphology.
Methods: A web-based exercise in which respondents associated KP descriptors, as identified through a scoping review of the published literature, to images from different disorders. Inter-observer agreement was assessed using the Krippendorff kappa alpha metric.
Results: Of the 76 descriptive terms identified by the scoping review, the most used included "mutton-fat" (n = 93 articles, 36%), "fine/dust" (n = 76, 29%), "stellate" (n = 40, 15%), "large" (n = 33, 12%), and "medium" (n = 33, 12%). The survey of specialists (n = 26) identified inter-observer agreement for these descriptors to be poor ("stellate," kappa: 0.15, 95% confidence interval 0.13-0.17), limited ("medium": 0.27, 95% CI 0.25-0.29; "dust/fine": 0.36, 95% CI 0.34-0.37), or moderate ("mutton fat": 0.40, 95% CI 0.36-0.43; "large": 0.43, 95% CI 0.39-0.46).
Conclusion: The clinical utility of KP morphology as an indicator of disease classification is limited by low inter-observer agreement.
Keywords: Consensus; diagnosis; uveitis.