Development and Validation of the QUT Corneal Nerve Grading Scale

作者：Efron Nathan^*; Lee Gawon; Lim Rebekah N; Qiu Andrew; Thea Edward; Ton Tammy; Wu Grant; Malik Rayaz A; Pritchard Nicola

来源：Cornea, 2014, 33(4): 376-381.

DOI：10.1097/ICO.0000000000000084

• cornea
• subbasal nerve plexus
• n vivo laser scanning corneal confocal microscope
• corneal nerve fiber length
• QUT Corneal Nerve Grading Scale

PURPOSE: The aim of this study was to develop and validate a grading scale to facilitate the estimation of the amount of nerve tissue in images of the corneal subbasal nerve plexus captured using in vivo laser scanning corneal confocal microscopy (LSCCM). %26lt;br%26gt;METHODS: Images of the corneal subbasal nerve plexus obtained using a Heidelberg LSCCM were sourced from a large image bank at the Queensland University of Technology (QUT). These images were used to construct a grading scale for depicting the amount of nerve tissue, ranging from 0 (sparse) to 4 (extensive). Twenty-five observers graded 20 images of a known corneal nerve fiber length (defined as the total length of nerves per unit area) on 2 occasions, at least 2 weeks apart. An equivalent calculated grade was determined for each test image from known values of corneal nerve fiber length. %26lt;br%26gt;RESULTS: The intraclass correlation coefficient for repeat gradings was 0.88 (P %26lt; 0.001). Intraobserver and interobserver repeatabilities were unrelated to the calculated grade (P = 0.467 and P = 0.530, respectively). Grading can be performed with average 95% confidence limits of +/- 1.2 grading units. Overall grading estimates did not differ between observers (P = 0.998). There was a strong agreement between the estimated and calculated grades (intraclass correlation coefficient = 0.92, P %26lt; 0.001). %26lt;br%26gt;CONCLUSIONS: We have developed the QUT Corneal Nerve Grading Scale, which is demonstrated to be repeatable, reliable, precise, and accurate. This tool provides clinicians and researchers with a simple and convenient pictorial reference for assessing, comparing, and monitoring the corneal subbasal nerve plexus with reference to LSCCM images.

• 出版日期2014-4