Classification of Limbal Stem Cell Deficiency Using Clinical and Confocal Grading

Abstract

Purpose: To grade the severity of limbal stem cell deficiency (LSCD) based on the extent of clinical presentation and central cornea basal epithelial cell density (BCD). Methods: This is a retrospective observational case-control study of forty-eight eyes of 35 patients with LSCD and 9 eyes of 7 normal subjects were included. Confocal images of the central cornea were acquired. A clinical scoring system was created based on the extent of limbal and corneal surface involvement. LSCD was graded as mild, moderate, and severe stages based on the clinical scores. The degree of BCD reduction was given a score of 0 to 3. Results: Compared with BCD in control eyes, BCD decreased by 23.0%, 40.4%, and 69.5% in the mild, moderate and severe stages of LSCD classified by the clinical scoring system, respectively. The degree of BCD reduction was positively correlated with larger limbal and corneal surface involvement, and when the central visual axis was affected (all p≤0.0005). The mean CDVA LogMAR was 0.0±0.0 in control eyes, 0.2±0.5 in mild LSCD, 0.6±0.4 in moderate LSCD, and 1.6±1.1 in severe LSCD (p<0.0001). There was a significant correlation between a higher clinical score and CDVA LogMAR (rho = 0.82; p<0.0001) and a greater decrease of BCD (rho = −0.78; p<0.0001). Conclusion: A clinical scoring system was developed to assess the extent of clinical presentation of LSCD. A classification system to grade the severity of LSCD can be established by combining the BCD score with the clinical score.

Labial Mucosa Stem Cells: Isolation, Characterization, and Their Potential for Corneal Epithelial Reconstruction

“…LSCD is thought to be one of the most challenging corneal diseases to diagnose and relates to the disruption of LSCs niche causing corneal opacity and vision loss. 30 Therefore, the vast number of stem cells and materials has been investigated for LSCD treatment purposes during the last several decades. 6 The first case of oral mucosa tissue sheets use for the treatment of eye burns was shown by Ballen in the early 1970s.…”

Current View of Diagnosing Small Fiber Neuropathy

“…Some major advantages are its non-invasiveness, its time-efficiency, its high reproducibility and its allowance for multiple replicates in both cross-sectional and longitudinal studies [ 60, 61 ]. Although normative values are available [ 62 ] and the technique seems very promising [ 63 ], outcomes seem to vary between different research groups and remains a topic of discussion [ 64 ]. Automated classification shows representative results [ 65 ].…”

Computerized Detection of Limbal Stem Cell Deficiency from Digital Cornea Images

“…The proposed classification algorithm: Rclassify, which is an extension to the Relief algorithm. The major drawback of Relief algorithm is its limitation to binary classification and also its jeopardizing of losing data [40], our proposed method Rclassify is more robust against incomplete data. Rclassify is characterized by its filtering technique that can analyze intrinsic data features regardless of the classifier type.…”