角膜缘干细胞缺乏症的定义、分类、诊断及分期的全球共识
Global Consensus on Definition, Classification, Diagnosis, and Staging of Limbal Stem Cell Deficiency.
作者信息
Deng Sophie X, Borderie Vincent, Chan Clara C, Dana Reza, Figueiredo Francisco C, Gomes José A P, Pellegrini Graziella, Shimmura Shigeto, Kruse Friedrich E
机构信息
Cornea Division, Stein Eye Institute, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA.
Quinze-Vingts National Eye Hospital, Faculté de Médecine Sorbonne Université, Paris, France.
出版信息
Cornea. 2019 Mar;38(3):364-375. doi: 10.1097/ICO.0000000000001820.
PURPOSE
Despite extensive knowledge gained over the last 3 decades regarding limbal stem cell deficiency (LSCD), the disease is not clearly defined, and there is lack of agreement on the diagnostic criteria, staging, and classification system among treating physicians and research scientists working on this field. There is therefore an unmet need to obtain global consensus on the definition, classification, diagnosis, and staging of LSCD.
METHODS
A Limbal Stem Cell Working Group was first established by The Cornea Society in 2012. The Working Group was divided into subcommittees. Four face-to-face meetings, frequent email discussions, and teleconferences were conducted since then to obtain agreement on a strategic plan and methodology from all participants after a comprehensive literature search, and final agreement was reached on the definition, classification, diagnosis, and staging of LSCD. A writing group was formed to draft the current manuscript, which has been extensively revised to reflect the consensus of the Working Group.
RESULTS
A consensus was reached on the definition, classification, diagnosis, and staging of LSCD. The clinical presentation and diagnostic criteria of LSCD were clarified, and a staging system of LSCD based on clinical presentation was established.
CONCLUSIONS
This global consensus provides a comprehensive framework for the definition, classification, diagnosis, and staging of LSCD. The newly established criteria will aid in the correct diagnosis and formulation of an appropriate treatment for different stages of LSCD, which will facilitate a better understanding of the condition and help with clinical management, research, and clinical trials in this area.
目的
尽管在过去30年里我们对角膜缘干细胞缺乏症（LSCD）已有广泛了解，但该疾病仍未得到明确界定，且从事该领域研究的治疗医师和科研人员在诊断标准、分期及分类系统方面尚未达成共识。因此，迫切需要就LSCD的定义、分类、诊断及分期达成全球共识。
方法
角膜学会于2012年首次成立了角膜缘干细胞工作组。该工作组又分为多个小组委员会。自那时起，工作组召开了四次面对面会议、多次邮件讨论及电话会议，在全面检索文献后，让所有参与者就战略计划和方法达成一致，最终就LSCD的定义、分类、诊断及分期达成了共识。随后成立了一个写作小组来起草本文稿，并对其进行了广泛修订以反映工作组的共识。
结果
就LSCD的定义、分类、诊断及分期达成了共识。明确了LSCD的临床表现和诊断标准，并建立了基于临床表现的LSCD分期系统。
结论
这一全球共识为LSCD的定义、分类、诊断及分期提供了一个全面的框架。新制定的标准将有助于正确诊断LSCD的不同阶段并制定适当的治疗方案，这将有助于更好地了解该疾病，并有助于该领域的临床管理、研究及临床试验。
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