Ophthalmology Unit, Department of Neuroscience, University of Padua, Padua, Italy.
Br J Ophthalmol. 2018 Oct;102(10):1448-1453. doi: 10.1136/bjophthalmol-2017-311171. Epub 2018 Jan 24.
To propose a new scoring system in the assessment of ocular surface epithelial damage in vernal keratoconjunctivitis (VKC).
25 consecutive patients with VKC (50 eyes) were evaluated using the Quality of Life in children with VKC (QUICK) questionnaire and objective clinical measures: fluorescein and lissamine green staining and cornea confocal microscopy (Heidelberg Retina Tomography 3). Oxford, Van Bljsterweld and a new system, the VKC-Collaborative Longitudinal Evaluation of Keratoconus study (CLEK) (VKC-CLEK) scores, were used to evaluate the epithelial damage after staining.
Mean Oxford and VKC-CLEK scores were significantly different after fluorescein staining (P<0.001), but significantly correlated (P<0.001; r=0.649). The same data were obtained comparing Van Bljsterweld and VKC-CLEK after lissamine green staining (P<0.001; r=0.760). In patient with limbal VKC, a statistically significant difference was found comparing new VKC-CLEK scores and Oxford or Van Bljsterweld scores (P<0.001), but not in tarsal VKC. A statistically superior concordance was found between QUICK and VKC-CLEK scores compared with standard staining scores values (P<0.001).
Oxford and Van Bijsterveld scores are not adequate for the evaluation of the epithelial damage in patients with limbal VKC because the staining patterns considered for these tests do not correspond to the staining patterns in patients with VKC. We propose a new scoring system, VKC-CLEK, to better evaluate both limbal and tarsal epithelial damage in patients with VKC.
提出一种新的评分系统，用于评估春季角结膜炎（VKC）患者的眼表上皮损伤。
对 25 例（50 只眼）VKC 患者进行了评估，采用儿童 VKC 生活质量（QUICK）问卷和客观临床指标：荧光素和丽丝胺绿染色以及角膜共焦显微镜（海德堡视网膜断层扫描 3）。使用 Oxford、Van Bljsterweld 和新的 VKC 协作纵向评估圆锥角膜研究（CLEK）（VKC-CLEK）评分来评估染色后的上皮损伤。
荧光素染色后 Oxford 和 VKC-CLEK 评分差异有统计学意义（P<0.001），但相关性良好（P<0.001；r=0.649）。在用丽丝胺绿染色后，Van Bljsterweld 和 VKC-CLEK 也得到了相同的数据（P<0.001；r=0.760）。在角膜缘型 VKC 患者中，新的 VKC-CLEK 评分与 Oxford 或 Van Bljsterweld 评分比较，差异有统计学意义（P<0.001），但在睑型 VKC 患者中无统计学意义。与标准染色评分值相比，QUICK 和 VKC-CLEK 评分之间具有更好的一致性（P<0.001）。
Oxford 和 Van Bijsterveld 评分不能充分评估角膜缘型 VKC 患者的上皮损伤，因为这些测试所考虑的染色模式与 VKC 患者的染色模式不对应。我们提出了一种新的评分系统 VKC-CLEK，以更好地评估 VKC 患者的角膜缘和睑缘上皮损伤。
