Interexaminer agreement of gonioscopy examinations in dogs using the European College of Veterinary Ophthalmologists Hereditary Eye Diseases grading scheme

Sep 28, 2026

Prospective observational study with a preregistered protocol evaluates interexaminer agreement using the 2022 ECVO-HED gonioscopy grading scheme in 60 client-owned dogs. Two ECVO diplomates performed randomized gonioscopy using a Koeppe lens and slit-lamp biomicroscopy at 10x on all eyes. Concordant breeding recommendations were found in 93% of eyes (110/118), with disagreement mainly in PLA and ICAW grading. Cohen’s kappa was moderate (0.62), and mixed model analysis found no significant examiner influence (p=.09).

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages12

Reading Time30 min

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Abstract

Objective and protocol

Animals and procedure

Results

Conclusions

Introduction

ECVO-HED scheme and breeding guidance

Gonioscopy and anatomical landmarks

PACG and related hereditary context

DOI: 10.1111/vop.13292 ORIGINAL REPORT Interexaminer agreement of gonioscopy examinationsin dogs using the European College of Veterinary Ophthalmologists Hereditary Eye Diseases grading scheme Niklas Holz1 | Malwina Ewa Kowalska2 | Simon Anton Pot1 | Antonella Rampazzo1 1Ophthalmology Section, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland 2Section of Epidemiology, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland Correspondence Antonella Rampazzo, Equine Department, Section Ophthalmology, Vetsuisse Faculty, University of Zurich, Winterthurerstrasse 260, Zurich 8057, Switzerland. [Email:](Email: antonella.rampazzo@uzh.ch)[ antonella.rampazzo@uzh.ch](Email: antonella.rampazzo@uzh.ch) Abstract Objective: Prospective observational study with preregistered study protocol to assess interexaminer agreement using the 2022 European College of Veterinary Ophthalmologists Hereditary Eye Disease (ECVO-HED) gonioscopy grading scheme. Animals Studied: Sixty client-owned dogs presented for gonioscopy as part of the required certification process prior to breeding. Procedure: Two ECVO diplomates with comparable clinical experience performed gonioscopy with a Koeppe gonioscopy lens and slit-lamp biomicroscope at 10x magnification on all eyes in a randomized fashion. Results: One hundred and eighteen of 120 eyes (60 dogs) were included. In 110/118 eyes (93%), both examiners provided the same breeding recommendation (yes/no) . This translated into an agreement on the final breeding recommendation in 58/60 dogs (97%) . Examiners disagreed on pectinate ligament abnormality (PLA) grading in 19/118 eyes and iridocorneal angle width (ICAW) grading in 9/118 eyes. PLA grading disagreement was mostly observed between neighboring grades. Disagreement between PLA and ICAW grading sometimes occurred within the same eye accounting for an observed disagreement in iridocorneal angle abnormality (ICAA) grading in 19/118 eyes in total. Cohen's kappa was Κ = 0.62 (95% TI 0.34–0.89), whereas maximum kappa was maxΚ = 0.82 (95% TI 0.59–1) . Mixed model analysis suggested no significant examiner influence on breeding recommendations (OR 0.17; 95% CI 0.02–1.12, p = .09) . Conclusions: Although examiners disagreed on ICAA grading in 19/118 eyes, this resulted in a different breeding recommendation (yes/no) in eight eyes and in two dogs only. Therefore, the use of the 2022 ECVO-HED gonioscopy grading scheme seems to result in examiners providing the same breeding recommendations in most cases. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made. © 2024 The Author(s). Veterinary Ophthalmology published by Wiley Periodicals LLC on behalf of American College of Veterinary Ophthalmologists. Veterinary Ophthalmology. 2026;29:e13292 . [https://doi.org/10.1111/vop.13292](https://doi.org/10.1111/vop.13292) [wileyonlinelibrary.com/journal/vop](wileyonlinelibrary.com/journal/vop | 1 of)[ |](wileyonlinelibrary.com/journal/vop | 1 of)[ 1 of](wileyonlinelibrary.com/journal/vop | 1 of) 12 KEYWORDS Cohen's kappa, gonioscopy scoring, grading system, iridocorneal angle, pectinate ligament abnormality, primary glaucoma 1 | INTRODUCTION The European College of Veterinary Ophthalmologists Hereditary Eye Disease (ECVO-HED) scheme is used uniformly across the European Union and in various neighboring countries by ECVO Diplomates and European Eye Scheme Examiners (ESE) to perform, score, and register the findings of eye examinations in breeding dogs. It provides guidelines to issue an eye examination certificate which is requested by many breed clubs to obtain approval for breeding. Breeding advice is derived from the ECVOHED manual.1 The ECVO-HED manual provides a list of dog breeds with s

FAQs

What was the study objective in this research?

To assess interexaminer agreement using the 2022 ECVO-HED gonioscopy grading scheme under a preregistered prospective protocol.

How were the dogs and examinations conducted?

Sixty client-owned dogs undergoing gonioscopy for breeding certification were examined by two ECVO diplomates using a Koeppe lens and slit-lamp biomicroscope at 10x in a randomized fashion.

What did the results show about agreement between examiners?

Breeding recommendations (yes/no) matched in 110/118 eyes (93%), corresponding to 58/60 dogs (97%). Disagreements occurred mainly for PLA and ICAW grading, with Cohen’s kappa of 0.62.

Sep 28, 2026

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