Abstract

To present a novel, free, web-based software tool (www.cyclocheck.com) for the assessment of objective cyclodeviation, based on measuring the disk-foveal angle (DFA) and to evaluate reproducibility of the results. Digital fundus photographs of both eyes of all study subjects were obtained using DRS CenterVue nonmydriatic fundus camera. Four separate measurements were made for each eye, and the DFA was calculated using Cyclocheck software independently by two observers to determine reproducibility and repeatability of the technique. The results were statistically analyzed using the interclass correlation coefficient (ICC) and the Bland-Altman method. A total of 32 subjects (mean age, 34.4; range, 12-83) were enrolled: 18 were orthophoric; 14, strabismic. The ICC for the intraobserver repeatability for one observer was 0.979 (95% CI, 0.970-0.985; P<0.0005) and for the other was 0.988 (95% CI, 0.983-0.991; P<0.0005). The ICC for the interobserver agreement was 0.994 (95% CI, 0.992-0.996; P<0.0005), indicating high reproducibility of the measurements. Cyclocheck can assess ocular torsion quickly and easily. It provides reliable and reproducible measurements of the DFA and thus objective cyclodeviation in both orthophoric and strabismic subjects.

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