Purpose

This study was designed to validate a semi-quantitative clinical assessment tool for cicatrising conjunctivitis (CC).

Methods

Fifty-five patients (109 eyes) with mucous membrane pemphigoid (MMP) and 31 patients (61 eyes) with Stevens-Johnson syndrome (SJS) were included. Three methods were used for validation: (1) comparison of inter- and intra-observer reproducibility for the components selected for the initial version of the tool, (2) quantitative measurement of the scarring component with a fornix depth measurer, compared with qualitative Tauber grading methodology, (3) the final version of the tool was compared with the published Sotozono SJS grading system. Main outcome measures included: inter- and intra-observer reproducibility, calculation of composite measures of scarring and morbidity, component redundancy, and correlation with other grading systems.

Results

Inter- and intra-observer agreement was moderate-to-excellent for graded components of conjunctival hyperaemia, upper and lower symblepharon, upper and lower fornix depth, corneal vascularisation, and corneal opacity. There was poor-to-good agreement for limitation of motility which was rejected from inclusion in the final tool. Composite scores for scarring components and morbidity components showed good-to-excellent agreement and distribution of ocular disease severity. Analysis of the composite components showed no redundancy - all components contributed independently. Comparison with both Tauber and Sotozono grading methodologies showed good concordance.

Conclusions

This study has developed the first validated assessment tool applicable to causes of CC. The tool is concise and discriminates patients with varying disease severity. It measures both disease activity and severity and is suitable for clinical and research applications.

中文翻译：

---

结膜炎结膜炎临床评估工具的验证。

目的

本研究旨在验证瘢痕结膜炎（CC）的半定量临床评估工具。

方法

包括55例黏膜天疱疮（MMP）患者和31例（61眼）史蒂文斯-约翰逊综合征（SJS）患者。三种方法用于验证：（1）比较为工具初始版本选择的组件在观察者之间和内部的可重复性，（2）与定性的Tauber相比，使用穹顶深度测量仪定量测量瘢痕形成组件分级方法，（3）将工具的最终版本与已发布的Sotozono SJS分级系统进行了比较。主要结果指标包括：观察者之间和观察者内部的可重复性，疤痕和发病率的综合量度的计算，组件冗余以及与其他分级系统的相关性。

结果

对于结膜充血，上，下共指，上，下穹depth深度，上，下角膜深度，角膜血管形成和角膜混浊的分级成分，观察者之间和观察者之间的同意程度中等至优秀。人们对运动性的限制达成了差强人意的协议，但由于将其纳入最终工具而被拒绝。瘢痕形成成分和发病成分的综合评分显示出良好的一致性和良好的眼部疾病分布。对复合组件的分析显示没有冗余-所有组件都是独立贡献的。与Tauber和Sotozono分级方法的比较显示出良好的一致性。

结论

这项研究已经开发出第一个适用于CC病因的经过验证的评估工具。该工具简洁明了，可区分疾病严重程度不同的患者。它可以测量疾病的活动性和严重性，适合于临床和研究应用。