title: Grading criteria for chronic ocular graft-versus-host disease: comparing the NIH eye score, Japanese dry eye score, and DEWS 2007 score.
abstract: Ocular graft-versus-host disease (GVHD) is a common complication after hematopoietic stem cell transplantation (HSCT). Here we compared the diagnostic rates of ocular GVHD, including its severity, prognosis and the agreement, obtained using three grading scales: the National Institutes of Health (NIH) eye score, Japanese dry eye score, and dry eye workshop score, by retrospectively reviewing the records of 82 patients who underwent HSCT. Tear dynamics and ocular surface assessments made 6-9 months after HSCT were used to determine ocular GVHD severity with the three scales. By the three scales, ocular GVHD was diagnosed in 56 patients (68.3%), 51 patients (62.2%), and 52 patients (63.4%), respectively. The Kappa coefficient was calculated to determine the agreement between scales for diagnosing ocular GVHD. The severity progression within two years after onset was also assessed by tear dynamics and ocular surface examination. The patients were categorized as no change, improved, or progressive. The three grading scales showed good agreement (Kappa = 0.87 to 0.97) in diagnosing patients with ocular GVHD, and the scores by all three were significantly associated with the patients' prognosis (p < 0.01). We recommend that multi-center research is needed for further validation and investigation.
authors.affiliation: Department of Ophthalmology, Keio University School of Medicine.
authors.forename: Yukako
authors.initials: Y
authors.lastname: Tatematsu
authors.affiliation: Department of Ophthalmology, Keio University School of Medicine.
authors.forename: Yoko
authors.initials: Y
authors.lastname: Ogawa
authors.affiliation: Department of Preventive Medicine and Public Health, Center for Clinical Research, Keio University School of Medicine, Tokyo, Japan.
authors.forename: Takayuki
authors.initials: T
authors.lastname: Abe
authors.affiliation: Department of Ophthalmology, Keio University School of Medicine.
authors.forename: Mizuka
authors.initials: M
authors.lastname: Kamoi
authors.affiliation: Department of Ophthalmology, Keio University School of Medicine.
authors.forename: Miki
authors.initials: M
authors.lastname: Uchino
authors.affiliation: Department of Ophthalmology, Keio University School of Medicine.
authors.forename: Yumiko
authors.initials: Y
authors.lastname: Saijo-Ban
authors.affiliation: Department of Ophthalmology, Keio University School of Medicine.
authors.forename: Saori
authors.initials: S
authors.lastname: Yaguchi
authors.affiliation: Department of Ophthalmology, Keio University School of Medicine.
authors.forename: Shin
authors.initials: S
authors.lastname: Mukai
authors.affiliation: Division of Hematology, Department of Medicine, Keio University School of Medicine.
authors.forename: Takehiko
authors.initials: T
authors.lastname: Mori
authors.affiliation: Division of Hematology, Department of Medicine, Keio University School of Medicine.
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Okamoto
authors.affiliation: Department of Ophthalmology, Keio University School of Medicine.
authors.forename: Kazuo
authors.initials: K
authors.lastname: Tsubota
mesh_terms: D000328:Adult; D005123:Eye / Q000473:pathology; D005128:Eye Diseases / Q000175:diagnosis* / Q000209:etiology / Q000473:pathology; D005260:Female; D006086:Graft vs Host Disease / Q000175:diagnosis* / Q000473:pathology; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D014481:United States