Pult Heiko, Murphy Paul J, Purslow Christine, Nyman Jeffrey, Woods Russell L
Cardiff University, School of Optometry and Vision Sciences, Maindy Road, Cathays, Cardiff CF24 4LU, UK.
Ophthalmic Physiol Opt. 2008 Jan;28(1):13-20. doi: 10.1111/j.1475-1313.2007.00534.x.
To investigate the appearance of limbal and bulbar hyperaemia in normal eyes, their relationship and the inter-observer agreement of clinical grading.
The right eyes of 120 healthy, non-contact lens-wearing subjects (m = 57, f = 63, median age = 45 years, range 18-77 years) were examined by two trained observers. Limbal and bulbar hyperaemia were scored using the Cornea and Contact Lens Research Unit (CCLRU) redness grading scales interpolated into 0.1 increments. Redness of four quadrants, and overall, were assessed, and quadrant-average redness was calculated. Inter-observer agreement was assessed at the start and end of the study (20 subjects each).
For limbal redness, the overall (1.62 +/- 0.46) (mean units +/- S.D.) was not significantly different from the quadrant-average (1.61 +/- 0.40) score. For bulbar redness, the overall (2.02 +/- 0.49) was higher than the quadrant-average (1.82 +/- 0.39) score (p < 0.0001). Significant correlations were found between bulbar and limbal quadrants (Pearson: r > or = 0.43, p < 0.0001). Significant differences in redness were found between quadrants (p < 0.0001), with nasal and temporal redder than superior and inferior quadrants. Small effects of age and gender were found for limbal redness. The inter-observer 95% limits of agreement were similar at the start and end of the study. They were larger for overall (0.57) compared with quadrant-average (0.28) redness.
For similar populations, a limbal redness above 2.5 or a bulbar redness above 2.6 (quadrant-average) or 3.0 (overall) may be considered abnormal. Limbal and bulbar redness were correlated. Quadrant-average scores are recommended instead of overall scores, as inter-observer agreement was better.
研究正常眼的角膜缘充血和球结膜充血的表现、它们之间的关系以及临床分级的观察者间一致性。
由两名经过培训的观察者对120名健康、不佩戴隐形眼镜的受试者（男性57名，女性63名，年龄中位数45岁，范围18 - 77岁）的右眼进行检查。使用角膜与隐形眼镜研究单位（CCLRU）的充血分级量表对角膜缘和球结膜充血进行评分，量表以0.1为增量进行插值。评估四个象限以及整体的充血情况，并计算象限平均充血程度。在研究开始和结束时（各20名受试者）评估观察者间的一致性。
对于角膜缘充血，整体评分（1.62±0.46）（平均值±标准差）与象限平均评分（1.61±0.40）无显著差异。对于球结膜充血，整体评分（2.02±0.49）高于象限平均评分（1.82±0.39）（p < 0.0001）。发现球结膜和角膜缘各象限之间存在显著相关性（Pearson相关系数：r≥0.43，p < 0.0001）。各象限之间的充血存在显著差异（p < 0.0001），鼻侧和颞侧比上象限和下象限更红。发现年龄和性别对角膜缘充血有较小影响。研究开始和结束时观察者间95%的一致性界限相似。整体充血的一致性界限（0.57）大于象限平均充血的一致性界限（0.28）。
对于相似人群，角膜缘充血高于2.5或球结膜充血高于2.6（象限平均）或3.0（整体）可被视为异常。角膜缘充血和球结膜充血相关。建议使用象限平均评分而非整体评分，因为观察者间一致性更好。
