Abstract
Purpose. To convert objective image analysis of anterior ocular surfaces into recognisable clinical grades, in order to provide a more
sensitive and reliable equivalent to current subjective grading
methods; a prospective, randomized study correlating clinical grading
with digital image assessment.
Methods. The possible range of clinical presentations Of bulbar and
palpebral hyperaemia, palpebral roughness and corneal staining were
represented by 4 sets of 10 images. The images were displayed in random
order and graded by 50 clinicians using both subjective CCLRU and Efron
grading scales. Previously validated objective image analysis was
performed 3 times oil each of the 40 images. Digital measures included
edge-detection and relative-coloration components. Step-wise regression
analysis determined correlations between the average subjective grade
and the objective image analysis measures.
Results. Average subjective grades Could be predicted by a combination
of the objective image analysis components. These digital ``grades''
accounted for between 69%, (for Efron scale-graded palpebral redness)
and 98% (for Efron scale-graded bulbar hyperaemia) of the subjective
variance.
Conclusions. The results indicate that clinicians may use a combination
of vessel areas and overall hue in their judgment of clinical severity
for certain conditions. Objective grading call take these aspects into
account, and be used to predict an average ``objective grade'' to be
used by a clinician in describing the anterior eye. These measures are
more sensitive and reliable than subjective grading while still
utilizing familiar terminology, and can be applied in research or
practice to improve the detection, and monitoring of ocular surface
changes.
Original language | English |
---|---|
Pages (from-to) | 273-278 |
Number of pages | 6 |
Journal | Optometry and Vision Science |
Volume | 86 |
Issue number | 3 |
DOIs | |
Publication status | Published - Mar 2009 |
Keywords
- ocular surface
- grading scale
- subjective
- objective
- image analysis
- conjunctiva
- cornea
- palpebral
- bulbar
- hyperaemia
- corneal staining