硬核性白内障的超声乳化吸除及人工晶体植入术

目的探讨白内障硬核的超声乳化碎核技术并评价其效果。方法利用改良的分割碎核法、保留皮质的旋转雕刻法及裸核旋转雕刻法对不同类型的硬核白内障进行乳化。结果硬核白内障６２只眼中,２６只眼成功的用改良的分割碎核法乳化,２３只眼用保留皮质的旋转雕刻法乳化,１３只眼用裸核旋转雕刻法乳化。均顺利植入折叠式人工晶体或５．５ｍｍ一体式ＰＭＭＡ人工晶体于囊袋内。术后３、５、３０天视力≥０．５者分别为４６只眼（７４．２％）、６０只眼（９６．８％）、６１只眼（９８．４％）。手术主要并发症有角膜水肿和后囊破裂。结论采用的三种乳化硬核方法适应于不同类型的各种硬核白内障,因安全易掌握,并发症少,值得在临床推广。     

高度近视白内障超声乳化摘除及人工晶体植入术

目的 分析高度近视白内障行超声乳化摘除及人工晶体植入术的疗效。方法 对眼轴≥２６ｍｍ的３６例（５３眼）采用原位碎核法行超声乳化摘除及人工晶体植入术,平均随访１０．５个月。结果 术后矫正视力≥０．５者占６０．３８％,脱盲率为９２．８５％,脱残率为７５．４７％。结论 高度近视白是超生乳化摘除及人工晶体植入术,效果满意。影响术后视力主要原因为高度近视所致眼底病,后囊破裂是造成术后视肉膜脱离最危险因素。     

高度近视合并白内障超声乳化及负,低度数人工晶体植入术

目的探讨高度近视合并白内障超声乳化及负、低度数人工晶体植入术的临床疗效。方法总计１０２例（１２０只眼）眼轴长≥２８ｍｍ的高度近视合并白内障患者,其中Ⅱ级核５只眼,Ⅲ级核８４只眼,Ⅳ级核１６只眼,Ⅴ级核１５只眼。采用巩膜隧道式切口及原位超声乳化碎核,超声能量设定Ⅱ或Ⅲ级核为５０％～６０％,超声时间４０～１３０秒,平均７１．３秒。Ⅳ或Ⅴ级核采用超声乳化中央切核和手法出核,超声能量设定为６５％～７０％,超声时间４８～８２秒,平均６８．７秒。结果术后１个月裸眼视力≥０．５者５２只眼（４３．４％）,矫正视力≥０．５者７５只眼（６２．６％）。术后随访１１～２２个月,平均１４．５个月。手术主要并发症为角膜水肿（６．７％）和后囊膜破裂（４．２％）。未见视网膜脱离及黄斑囊样水肿。结论超声乳化联合负、低度数人工晶体植入适合于高度近视合并白内障患者,具有恢复良好视功能、矫正屈光不正、预防视网膜脱离、减少后发障及手术并发症等优点,值得临床推广应用     

超声乳化白内障吸出术中和术后早期并发症的观察

目的:探讨超声乳化白内障吸出手术并发症的原因和处理方法。方法:观察了采用原位碎核和虹膜平面碎核法分别对212例(233眼)患者行超声乳化白内障吸出术的术中和术后早期并发症。结果:术中玻璃体脱出20眼(8.6％),虹膜损伤13眼(5.6％),前房出血1眼(0.4％)。术后角膜持续水肿3眼(1.3％),后囊膜混浊7眼(3.0％),炎症反应2眼(0.9％),人工晶体偏位1眼(0.4％),切口渗漏2眼(0.9％),术后前房出血1眼(0.4％)。结论:玻璃体脱出及虹膜损伤是初期进行超声乳化白内障吸出术较常见的并发症。采用原位碎核法出现的玻璃体脱出及虹膜损伤少于虹膜平面碎核法。眼科学报1998;14:105—107。     

特殊超声乳化削梨法治疗老年性白内障1817例

目的：探讨削梨法超声乳化白内障碎核技术及其临床效果。方法：老年性白内障患1817例2144眼采用轮转削梨法超声乳化碎核技术进行手术。术后1～5d复查术眼情况及视力，按年龄进行分组，所有数据均用SPSS统计软件进行统计处理。结果：Ⅳ～Ⅴ级硬核737眼，占34．38％，均能安全超声乳化；术中后囊破裂率低，为1．45％；超声乳化时间7～221(平均75．41)s／眼：手术完成时间10～20(平均16)min／眼；术后1～5d裸眼视力平均0．53；术后视力与年龄的相关性有高度显性统计学意义(P＜0．0001)。结论：削梨法碎核时能量利用率高，用较少的总超乳能量，即能完成核乳化全过程，并且核旋转乳化过程中眼内器械活动范围小，对眼内组织影响较少，安全性高，更适合于各种硬度晶状体核、过熟核及小瞳孔下的乳化手术，同时还适应于超声乳化的各种联合手术。     

拦截劈核技术在硬核白内障超声乳化中的应用

目的 探讨改良拦截劈核技术在硬核白内障超声乳化手术中的应用。方法 采用改良拦截劈核乳化技术，施行白内障超声乳化手术165例（186眼），其中Ⅲ级核99眼，Ⅵ级核87眼。结果 术后第1天视力≥0．5者占85．5％，≥1．0者占21．2％，角膜轻中度水肿29眼占15．6％，后囊破裂7眼占3．8％。结论 采用改良拦截劈核技术，使分割硬的晶体核变得容易，减少了能量的使用，缩短了乳化时间，安全、易操作，值得推广应用。     

高度近视白内障超声乳化摘除及负低度后房型人工晶体植入术

目的研究超声乳化对高度近视眼合并白内障，同时植入负低度数后房型人工晶体最佳效果。方法采用角膜隧道切口，原位超声乳化碎核，超声能量设立Ⅱ或Ⅲ级核为50％～60％，超声时间50～120s，22例（29眼）眼轴长≥28mm的高度近视合并白内障。结果术后1个月裸眼视力≥0．5者22眼（75．9％），矫正视力≥1．0者7眼（24．1％），手术主要并发症为角膜水肿（7．2％），未见视网膜脱离及黄斑囊样水肿。结论超声乳化具有切口小、散光小、联合负低度数人工晶体植入适合于高度近视合并白内障，预防视网膜脱离或减少后发障及手术并发症等优点，恢复良好的视功能。     

挤切碎核技术在硬核性白内障超声乳化术中应用

目的 探讨挤切碎核技术在硬核性白内障超声乳化术中的应用。方法 对Ⅳ级、Ⅴ级核老年性白内障９３眼采用挤切碎核技术进行白内障超声乳化手术。结果 术后第３天、１０天、月视力≥０．５，分别为５８眼（６２％）、８８眼（９５％）、７３眼（９７％），平均有效时间４２秒，尚未出现后囊破裂。手术主要并发症有角膜水肿。结论 采用挤切碎核技术分割坚韧的晶状体核变得更加容易，缩短初学者的“学习曲线”，大大缩短了手术的时间     

手法碎核在白内障超声乳化摘除术中的应用

目的：观察手法碎核技术在白内障超声乳化摘除术中的应用效果。方法：选取2011-05/10老年性白内障132例179眼,其中男56例82眼,女76例97眼;年龄53～74（平均67.7±6.4）岁。排除伴有晶状体脱位、青光眼及葡萄膜炎等。手法碎核后再行超声乳化术,观察手术中超声能量和作用时间、术后视力和角膜水肿等,随访时间1wk。结果：手法碎核后超声乳化白内障摘除术中所需超声能量低,术后角膜水肿等术后并发症的发生率较低。结论：手法碎核技术在白内障超声乳化摘除术中的应用是安全有效的。     

不同碎核法超声乳化白内障吸除术临床观察

目的：比较不同碎核法超声乳化白内障吸除折叠式人工晶体植入术的临床效果。方法：将46例（160只眼）白内障患，随机分成两组,乳化分核组72例（80只眼），手法劈核组74例（80只眼），行上方巩膜反收状或角膜缘切口，分别采用乳化分核及手法劈核行超声乳化白内障吸除术，同时植入丙烯酸酯类三片式折叠式人工晶体。结果：术后随诊3－12个月，乳化分核组术后1天，1周，1个月和3个月矫正视力＞0．5分别为72．3％，80．6％，88．2％和90．2％，手法劈核组术后1天，1周，1个月和3个月矫正视力＜0．5分别为73．8％，81．2％，89．8％和92．1％，两组比较差异无显性（P＞0．05），乳化分核组与手法核组平均超声能量时间分别为45．7″和18．4″，两组比较差异有显性（P＜0．05），结论：小切口超声乳化白内障吸除折叠式人工晶体植入术，而种碎核方法效果差异无显性，对于IV级以上硬核，采用手法劈核方法可减少超声能量，缩短手术时间，从而明显降低了超声乳化手术对角膜内皮的损伤。     

Using Decision Curve Analysis to Evaluate Common Strategies for Myopia Screening in School-Aged Children

Purpose: To evaluate common strategies for screening myopia.

Methods: A total of 2,248 children aged 6 to 12 years from five randomly selected primary schools were included for the screening. Enrolled study participants underwent distant uncorrected visual acuity (UCVA, Standard Logarithmic Visual Acuity E Chart) and non-cycloplegic auto-refraction (NCAR, Topcon KR-8800). Among them, 1,639 children (72.9%) accepted cycloplegic auto-refraction. Taking rejection of cycloplegia into account, receiver operating characteristic curves were drawn to compare the accuracies of the four strategies (I, Cycloplegic auto-refraction; II, NCAR; III, UCVA; IV, Combination of UCVA and NCAR). Decision curve analysis (DCA) was used to compare net benefits. Tenfold cross-validation was used for statistical analyses.

Results: For myopia (spherical equivalent refraction, SE ≤ ?0.5D) screening, the mean sensitivities were 73.79% (SD: 5.40%), 85.57% (6.84%), 59.71% (13.49%), and 85.06% (6.68%) for Strategy I to IV; with mean specificities of 100% (0%), 87.43% (4.27%), 89.74% (10.25%), and 88.65% (5.07%), respectively. For screening early myopia (SE ≤ ?0.5D and ≥?1.0D), the mean sensitivities were 73.44% (7.69%), 82.39% (5.32%), 54.27% (14.58%), and 81.76% (9.60%) for Strategy I to IV; with mean specificities of 100% (0%), 79.13% (4.86%), 85.48% (9.86%), and 81.17% (4.16%). Based on DCA, the net benefits of Strategy IV were the highest, with the probability thresholds ranging from 12% to 50%, after adjusting the TestHarms. For early myopia, the net benefits of Strategy IV were the highest with the probability threshold ranging from 5% to 34%.

Conclusion: Combination of UCVA and NCAR produced the highest net benefits for myopia screening.     

Etiology and antibacterial susceptibility pattern of community-acquired bacterial ocular infections in a tertiary eye care hospital in south India

Aims:

To identify the etiology, incidence and prevalence of ocular bacterial infections, and to assess the in vitro susceptibility of these ocular bacterial isolates to commonly used antibiotics.

Materials and Methods:

Retrospective analysis of consecutive samples submitted for microbiological evaluation from patients who were clinically diagnosed with ocular infections and were treated at a tertiary eye care referral center in South India between January 2002 and December 2007.

Results:

A total of 4417 ocular samples was submitted for microbiological evaluation, of which 2599 (58.8%) had bacterial growth, 456 (10.3%) had fungal growth, 15 (0.34%) had acanthamoebic growth, 14 (0.32%) had mixed microbial growth and the remaining 1333 (30.2%) had negative growth. The rate of culture-positivity was found to be 88% (P < 0.001) in eyelids’ infection, 70% in conjunctival, 69% in lacrimal apparatus, 67.4% in corneal, 51.6% in intraocular tissues, 42.9% in orbital and 39.2% in scleral infections. The most common bacterial species isolated were Staphylococcus aureus (26.69%) followed by Streptococcus pneumoniae (22.14%). Sta. aureus was more prevalent more in eyelid infections (51.22%; P = 0.001) coagulase-negative staphylococci in endophthalmitis (53.1%; P = 0.001), Str. pneumoniae in lacrimal apparatus and corneal infections (64.19%; P = 0.001), Corynebacterium species in blepharitis and conjunctivitis (71%; P = 0.001), Pseudomonas aeruginosa in keratitis and dacryocystitis (66.5%; P = 0.001), Haemophilus species in dacryocystitis and conjunctivitis (66.7%; P = 0.001), Moraxella lacunata in blepharitis (54.17%; P = 0.001) and Moraxella catarrhalis in dacryocystitis (63.83%; P = 0.001). The largest number of gram-positive isolates was susceptible to moxifloxacin (98.7%) and vancomycin (97.9%), and gram-negative isolates to amikacin (93.5%) and gatifloxacin (92.7%).

Conclusions:

Gram-positive cocci were the most frequent bacteria isolated from ocular infections and were sensitive to moxifloxacin and vancomycin, while gram-negative isolates were more sensitive to amikacin and gatifloxacin.     

Tribal Odisha Eye Disease Study (TOES) Report # 9. Eye diseases and retinal disorders in an adult and elderly tribal community in Odisha,India - A community hospital-based study

Purpose:To measure the proportion of people with major ophthalmic and retinal disorders in the tribal and non-tribal people presenting to a community eye hospital in an Indian state with a sizeable tribal population.Methods:Hospital-based cross-sectional retrospective study of all new adult patients, examined between September 2015 and June 2020. A tribal was defined as per the Indian ethnic classification. Blindness and visual impairment were defined as per the WHO standards. Diabetes and hypertension were defined as per Indian standards. The proportion of common ophthalmic and retinal disorders between the tribal and non-tribal community were compared.Results:This cohort consisted of 76,166 people (45.8%; n = 34,869, tribal); 39.4% (n = 29,989; non-tribal 23.6% and tribal 15.8%) people had ophthalmic disorders. In the examined people 2.3% were blind (higher in tribal community 4.7% versus 0.8%; P < 0.001) and 8.4% had moderate-to-severe visual impairment (higher in tribal community 14.4% versus 4.4%; P < 0.001). Refractive error (64.4%; higher in non-tribal community, 77.3% versus 44.6%, P < 0.001) and operable cataract (23.9%; higher in tribal community, 40.9% versus 11.8%, P < 0.001) were the principal ophthalmic disorders. Retinal disorders were higher in non-tribal people (5.9% vs. 2.9%; P < 0.001), but the tribal group had higher proportion of retinitis pigmentosa (20% vs. 6.4%; P < 0.001) and lower proportion of diabetic retinopathy (8% vs. 40.7%; P < 0.001).Conclusion:The health-seeking behavior of the tribal community in India is low. A tribal person in India apparently visits the hospital when vision is grossly affected. It calls for greater advocacy, increased access to healthcare, and a larger population-based study.     

Magnetic resonance imaging for tumor restaging after chemotherapy in retinoblastoma with optic nerve invasion

Purpose: Extraocular retinoblastoma with optic nerve invasion is treated by a multimodal protocol consisting of neoadjuvant chemotherapy, enucleation, and adjuvant therapy. This study was conducted to evaluate the performance of magnetic resonance imaging (MRI) used for tumor restaging in these children after systemic chemotherapy administration.

Methods: Contrast-enhanced MRI scan of orbits and brain was performed at diagnosis and patients were treated with neoadjuvant chemotherapy. After chemotherapy, MRI scan was repeated for tumor restaging and residual post-laminar thickening and/or enhancement of the affected optic nerve, if any, was recorded. MRI findings were correlated with histopathology in enucleated specimens. The main outcome measures were specificity, sensitivity, and accuracy of MRI in predicting post-laminar invasion after neoadjuvant chemotherapy.

Results: A total of 46 eyes (46 patients) were studied. Optic nerve thickening on MRI had a sensitivity, specificity, and accuracy of 100% (95% Confidence Interval (CI): 64.6–100%), 76.9% (95% CI: 61.7–87.4%), and 80.4% (95% CI: 66.8–89.4%), respectively. Optic nerve enhancement had a sensitivity, specificity, and accuracy of 85.7% (95% CI: 48.7–97.4%), 79.5 % (95% CI: 64.5–89.2%), and 80.4% (95% CI: 66.8–89.4%), respectively. Combined thickening and enhancement of the optic nerve had a sensitivity, specificity, and accuracy of 100% (95% CI: 60.9–100%), 82.4% (95% CI: 66.5–91.7%), and 85% (95% CI: 70.9–92.9%), respectively.

Conclusion: MRI is a valuable tool for restaging of retinoblastoma and predicting residual optic nerve disease after neoadjuvant chemotherapy. Combined thickening and enhancement on MRI appeared to be a more reliable indicator of post-laminar invasion as compared to thickening or enhancement alone.     

Stand der Immunprophylaxe und -therapie bei perforierender Keratoplastik

ZusammenfassungHintergrund Zur Prophylaxe immunologischer Transplantatreaktionen stehen unterschiedliche Strategien zur Verfügung. Ziel der vorgelegten Untersuchung war es, die aktuelle klinische Praxis bei Planung und Nachsorge der perforierenden Keratoplastik (KPL) im deutschsprachigen Raum zu erfassen.Methode Hierzu wurde ein Fragebogen an 148 Mitglieder der Sektion Kornea der Deutschen Ophthalmologischen Gesellschaft (DOG) verschickt. Der Rücklauf umfasste 69 (47%) Fragebögen aus 69% der vertretenen Institutionen; 39% der Antworten stammen aus Einrichtungen mit <50 KPL/Jahr, 15% aus Institutionen mit >100 KPL/Jahr, 4% aus Kliniken mit >300 KPL/Jahr.Ergebnisse Von 13% der Befragten wird nie ein gematchtes Transplantat verwendet, von 22% bei jeder Risiko-KPL, von 1,5% bei jeder KPL. In der Normalrisikosituation behandeln 1,5% <2 Wochen, 66% 3–12 Monate, 6,5% >1 Jahr mit topischen Steroiden, 35% behandeln zusätzlich mit systemischen Steroiden. Cyclosporin A (CsA; 92%) ist neben Steroiden (80%) das am häufigsten eingesetzte systemische Immunsuppressivum in der Hochrisikosituation, während MTX nur von 9,5% verwendet wird. Die Dauer der immunsuppressiven Therapie reicht von <3 Monate (9%) bis zu >12 Monate (14%). Die postoperative Therapie nach KPL bei Herpes umfasst lokales (51%) und systemisches Aciclovir <3 (26%) und >3 Wochen (67%), außerdem systemische Immunsuppressiva (37%). Bei der Limbusinsuffizienz war die Stammzelltransplantation die am häufigsten angegebene Therapieoption (51%), gefolgt von Amnionmembranaufnähung (32%) und keratolimbaler KPL (27%). Die akute Immunreaktion wird vornehmlich mit Steroiden behandelt: topisch (95%), subkonjunktival (29%), intrakameral (1,5%). Systemische Steroide werden oral (48%) und i.v. (42%) gegeben,12% behandeln mit topischem CsA.Schlussfolgerung Neben therapeutischen Optionen, die als common- practice einzuschätzen sind (z. B. syst. CsA), ist die klinische Praxis in anderen Punkten sehr heterogen, was der noch geringen Zahl an evidence-based Studienergebnissen entspricht.     

Mapping Trachoma in the Solomon Islands: Results of Three Baseline Population-Based Prevalence Surveys Conducted with the Global Trachoma Mapping Project

ABSTRACT

Purpose: We sought to complete the baseline trachoma map of the Solomon Islands by establishing prevalences of active trachoma and trichiasis in the provinces of Choiseul, Western, Rennell-Bellona, and Temotu.

Methods: Using the standardized methodology developed for the Global Trachoma Mapping Project, we conducted cross-sectional community-based surveys from September to November 2013. Choiseul and Western provinces were each mapped as separate evaluation units (EUs); Rennell-Bellona and Temotu were combined to form a third EU.

Results: A total of 9819 individuals were sampled for inclusion, with 9224 (93.3%) consenting to examination, of whom 4587 (46.3%) were female. Survey teams visited 82 villages, and surveyed 2448 households. Two EUs had prevalences of trachomatous inflammation – follicular (TF) in 1–9-year-olds over the 10% threshold at which WHO recommends mass distribution of azithromycin for at least 3 years (Western 20.4%, 95% confidence interval, CI 15.6–26.3%; Rennell-Bellona/Temotu 22.0%, 95% CI 18.5–26.0%). Choiseul had a TF prevalence of 6.1% (95% CI 4.1–8.6%), and met the criterion for a single round of mass antibiotic distribution before re-survey. The adjusted prevalences of trichiasis in those aged 15+ years were 0.0% (95% CI 0.0–0.2%) in Choiseul, 0.16% (95% CI 0.0–0.5%) in Western, and 0.10% (95% CI 0–0.3%) in Rennell-Bellona/Temotu provinces. All three EUs require implementation of the facial cleanliness and environmental improvement components of the trachoma elimination strategy.

Conclusion: Active trachoma is prevalent in the Solomon Islands. However, there is little evidence of the blinding complications of trachoma being a public health problem there. Further research into the explanation for this phenomenon is warranted.     

Population-Based Trachoma Mapping in Six Evaluation Units of Papua New Guinea

ABSTRACT

Purpose: We sought to determine the prevalence of trachomatous inflammation – follicular (TF) in children aged 1–9 years, and trachomatous trichiasis (TT) in those aged ≥15 years, in suspected trachoma-endemic areas of Papua New Guinea (PNG).

Methods: We carried out six population-based prevalence surveys using the protocol developed as part of the Global Trachoma Mapping Project.

Results: A total of 19,013 individuals were sampled for inclusion, with 15,641 (82.3%) consenting to participate. Four evaluation units had prevalences of TF in children ≥10%, above which threshold the World Health Organization (WHO) recommends mass drug administration (MDA) of azithromycin for at least three years; Western Province (South Fly/Daru) 11.2% (95% confidence interval, CI, 6.9–17.0%), Southern Highlands (East) 12.2% (95% CI 9.6–15.0%), Southern Highlands (West) 11.7% (95% CI 8.5–15.3%), and West New Britain 11.4% (95% CI 8.7–13.9%). TF prevalence was 5.0–9.9% in Madang (9.4%, 95% CI 6.1–13.0%) and National Capital District (6.0%. 95% CI 3.2–9.1%) where consideration of a single round of MDA is warranted. Cases of TT were not found outside West New Britain, in which four cases were seen, generating an estimated population-level prevalence of TT in adults of 0.10% (95% CI 0.00–0.40%) for West New Britain, below the WHO elimination threshold of 0.2% of those aged ≥15 years.

Conclusion: Trachoma is a public health issue in PNG. However, other than in West New Britain, there are few data to support the idea that trachoma is a cause of blindness in PNG. Further research is needed to understand the stimulus for the active trachoma phenotype in these populations.     

Prevalence and Causes of Visual Impairment and Blindness in Adults Aged 45 Years and Older from Parintins: The Brazilian Amazon Region Eye Survey

Purpose: To determine the prevalence and causes of visual impairment and blindness in adults aged 45 years and older from Parintins, Brazilian Amazon Region.

Methods: A random cluster sampling method was used to identify subjects 45 years of age and older from urban and rural census sectors of Parintins city, Amazonas State, from March 2014 to May 2015. Participants underwent a detailed ocular examination, including presenting (PVA) and best corrected visual acuity (BCVA). The main cause of PVA<20/32 per eye was determined.

Results: A total of 2384 subjects were enumerated and 2041 (85.6%) examined. The prevalence of presenting mild visual impairment – MiVI (<20/32 – ≥20/63) in the better-seeing eye was 17.0% [95% CI: 15.3–18.7%], and 8.5% [95% CI: 7.3–9.7%] with best correction. The prevalence of presenting moderate visual impairment – MVI (<20/63 – ≥20/200) was 18.4% [95% CI: 16.2–20.6%], and 6.9% [95% CI: 5.8–8.0%] with best correction. The prevalence of presenting bilateral VA <20/200 was 4.3% [95% CI: 3.6–5.0%], and 3.3% [95% CI: 2.5–4.0%] with best correction and increased with older age. Cataract (47.8%) and glaucoma (7.5%) were its main causes. In less severely affected eyes, uncorrected refractive errors (MVI: 42.6%; MiVI: 79.0%), cataract (MVI: 40.6%; MiVI: 13.7%) and pterygium (MVI: 7.6%; MiVI: 2.7%) were the main causes.

Conclusions: Most cases of visual impairment in Parintins are either preventable or treatable, and public health initiatives should target cataract surgical services and refraction with spectacle provision.     

Multicenter prospective validation study for international chronic ocular graft-versus-host disease consensus diagnostic criteria

PurposeTo validate the international chronic ocular graft-versus-host disease (GVHD) diagnostic criteria (ICCGVHD) compared to the National Institute of Health diagnostic criteria 2014 (NIH2014) for chronic ocular GVHD.MethodsBetween 2013 and 2019, the study enrolled 233 patients with or without chronic ocular GVHD combined with the presence or absence of systemic chronic GVHD in an internationally prospective multicenter and observational cohort from 9 institutions. All patients were evaluated for four clinical parameters of ICCGVHD.ResultsThe relation between the ICCGVHD score (0-11) and NIH2014 eye score (0–4) was relatively high (r = 0.708, 95% CI: 0.637–0.767, p < 0.001). The sensitivity and specificity of ICCGVHD for NIH 2014 for 233 patients were 94.3% (95% CI: 89.6%–98.1%) and 71.7% (95% CI: 63.0–79.5%), respectively (cutoff value of the ICCGVHD score = 6). The positive predictive value was 77.1% (95% CI: 71.1%–82.1%), and the negative predictive value was 87.0% (95% CI:81.6–92.5%). For the patients with systemic GVHD (n = 171), the sensitivity and specificity were 94.2% and 67.2%, respectively (ICCGVHD-score cutoff value = 6). By receiver operating characteristic (ROC) curve analysis, the area under the curve (AUC) was 0.903 (95% CI: 0.859–0.948). For patients without systemic GVHD (n = 62), the sensitivity and specificity were 100% and 76.7%, respectively (ICCGVHD-score cutoff value = 6). The AUC was 0.891 (95% CI 0.673–1.000).ConclusionsGood sensitivity, specificity, predictive value and correlation were found between ICCGVHD and NIH2014. ICCGVHD scores ≥6 can be useful to diagnose ocular GVHD with or without systemic GVHD for clinical research.