Novel Grading Scale for Conjunctival Inflammation in Cicatrizing Conjunctivitis Associated with Pemphigoid

Area of Science:

• Ophthalmology
• Dermatology

Background:

• Cicatrizing conjunctivitis associated with Pemphigoid presents a challenge in objectively quantifying conjunctival inflammation.
• Standardized assessment tools are needed for consistent clinical evaluation and research.

Purpose of the Study:

• To develop and validate a novel grading scale for conjunctival inflammation in Pemphigoid-related cicatrizing conjunctivitis.
• To create a tool that incorporates both visual and descriptive elements for improved accuracy.

Main Methods:

• Retrospective analysis of 6,969 digital slit-lamp images from 113 patients with cicatrizing conjunctivitis secondary to Pemphigoid.
• Prospective assessment of anonymized conjunctival images by a fellowship-trained ophthalmologist specializing in Pemphigoid.
• Development of a 4-point grading scale (0-4+) with verbal descriptors and visual composites.

Main Results:

• A total of 452 high-clarity images were selected, representing the best image per eyelid per session.
• Images were categorized into five groups (0-4+) based on inflammation severity.
• Representative images and verbal descriptors were compiled to form the visual composite scale.

Conclusions:

• A novel 4-point grading scale was successfully developed for conjunctival inflammation in Pemphigoid-associated cicatrizing conjunctivitis.
• The scale integrates visual and verbal components, offering a standardized method for inflammation assessment.