Sophie X Deng1, Vincent Borderie2, Clara C Chan3, Reza Dana4, Francisco C Figueiredo5, José A P Gomes6, Graziella Pellegrini7, Shigeto Shimmura8, Friedrich E Kruse9. 1. Cornea Division, Stein Eye Institute, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA. 2. Quinze-Vingts National Eye Hospital, Faculté de Médecine Sorbonne Université, Paris, France. 3. Department of Ophthalmology & Vision Sciences Toronto, University of Toronto, ON, Canada. 4. Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA. 5. Department of Ophthalmology, Royal Victoria Infirmary and Institute of Genetic Medicine, Newcastle University, Newcastle upon Tyne, United Kingdom. 6. Department of Ophthalmology and Visual Sciences, Escola Paulista de Medicina, Universidade Federal de São Paulo (EPM/UNIFESP), Brazil. 7. Holostem Terapie Avanzate, Centre for Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy. 8. Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan. 9. Department of Ophthalmology, University Hospital Erlangen and Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany.
Abstract
PURPOSE: Despite extensive knowledge gained over the last 3 decades regarding limbal stem cell deficiency (LSCD), the disease is not clearly defined, and there is lack of agreement on the diagnostic criteria, staging, and classification system among treating physicians and research scientists working on this field. There is therefore an unmet need to obtain global consensus on the definition, classification, diagnosis, and staging of LSCD. METHODS: A Limbal Stem Cell Working Group was first established by The Cornea Society in 2012. The Working Group was divided into subcommittees. Four face-to-face meetings, frequent email discussions, and teleconferences were conducted since then to obtain agreement on a strategic plan and methodology from all participants after a comprehensive literature search, and final agreement was reached on the definition, classification, diagnosis, and staging of LSCD. A writing group was formed to draft the current manuscript, which has been extensively revised to reflect the consensus of the Working Group. RESULTS: A consensus was reached on the definition, classification, diagnosis, and staging of LSCD. The clinical presentation and diagnostic criteria of LSCD were clarified, and a staging system of LSCD based on clinical presentation was established. CONCLUSIONS: This global consensus provides a comprehensive framework for the definition, classification, diagnosis, and staging of LSCD. The newly established criteria will aid in the correct diagnosis and formulation of an appropriate treatment for different stages of LSCD, which will facilitate a better understanding of the condition and help with clinical management, research, and clinical trials in this area.
PURPOSE: Despite extensive knowledge gained over the last 3 decades regarding limbal stem cell deficiency (LSCD), the disease is not clearly defined, and there is lack of agreement on the diagnostic criteria, staging, and classification system among treating physicians and research scientists working on this field. There is therefore an unmet need to obtain global consensus on the definition, classification, diagnosis, and staging of LSCD. METHODS: A Limbal Stem Cell Working Group was first established by The Cornea Society in 2012. The Working Group was divided into subcommittees. Four face-to-face meetings, frequent email discussions, and teleconferences were conducted since then to obtain agreement on a strategic plan and methodology from all participants after a comprehensive literature search, and final agreement was reached on the definition, classification, diagnosis, and staging of LSCD. A writing group was formed to draft the current manuscript, which has been extensively revised to reflect the consensus of the Working Group. RESULTS: A consensus was reached on the definition, classification, diagnosis, and staging of LSCD. The clinical presentation and diagnostic criteria of LSCD were clarified, and a staging system of LSCD based on clinical presentation was established. CONCLUSIONS: This global consensus provides a comprehensive framework for the definition, classification, diagnosis, and staging of LSCD. The newly established criteria will aid in the correct diagnosis and formulation of an appropriate treatment for different stages of LSCD, which will facilitate a better understanding of the condition and help with clinical management, research, and clinical trials in this area.
Authors: Abraham Solomon; Pierre Ellies; David F Anderson; Amel Touhami; Martin Grueterich; Edgar M Espana; Seng-Ei Ti; Eiki Goto; William J Feuer; Scheffer C G Tseng Journal: Ophthalmology Date: 2002-06 Impact factor: 12.079
Authors: G Pellegrini; E Dellambra; O Golisano; E Martinelli; I Fantozzi; S Bondanza; D Ponzin; F McKeon; M De Luca Journal: Proc Natl Acad Sci U S A Date: 2001-03-13 Impact factor: 11.205
Authors: Sophie X Deng; Vincent Borderie; Clara C Chan; Reza Dana; Francisco C Figueiredo; José A P Gomes; Graziella Pellegrini; Shigeto Shimmura; Friedrich E Kruse Journal: Cornea Date: 2019-12 Impact factor: 2.651