PT  - JOURNAL ARTICLE
AU  - Leonardi, Andrea
AU  - Lazzarini, Daniela
AU  - La Gloria Valerio, Alvise
AU  - Scalora, Tania
AU  - Fregona, Iva
TI  - Corneal staining patterns in vernal keratoconjunctivitis: the new VKC-CLEK scoring scale
AID  - 10.1136/bjophthalmol-2017-311171
DP  - 2018 Oct 01
TA  - British Journal of Ophthalmology
PG  - 1448--1453
VI  - 102
IP  - 10
4099  - http://bjo.bmj.com/content/102/10/1448.short
4100  - http://bjo.bmj.com/content/102/10/1448.full
SO  - Br J Ophthalmol2018 Oct 01; 102
AB  - Aim To propose a new scoring system in the assessment of ocular surface epithelial damage in vernal keratoconjunctivitis (VKC).Methods 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.Results Mean Oxford and VKC-CLEK scores were significantly different after fluorescein staining (P&amp;lt;0.001), but significantly correlated (P&amp;lt;0.001; r=0.649). The same data were obtained comparing Van Bljsterweld and VKC-CLEK after lissamine green staining (P&amp;lt;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&amp;lt;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&amp;lt;0.001).Conclusions 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.