title: Nature and incidence of severe limbal stem cell deficiency in Australia and New Zealand.
abstract: BACKGROUND
  This study aimed to determine the nature and incidence of severe limbal stem cell deficiency (LSCD) in Australia and New Zealand.
  
  
  METHODS
  A 1-year pilot surveillance study with a 1-year follow-up period was conducted in association with the Australian and New Zealand Ophthalmic Surveillance Unit.
  
  
  METHODS
  The study included patients reported by practising ophthalmologists on the Surveillance Unit's database.
  
  
  METHODS
  Ophthalmologists were provided with a definition of severe limbal stem cell deficiency, contacted on a monthly basis by the Unit and asked to report newly diagnosed cases.
  
  
  METHODS
  Severe LSCD was defined as at least 6 clock hours of whorl-like epitheliopathy, an opaque epithelium arising from the limbus, late fluorescein staining of the involved epithelium and superficial corneal neovascularization or conjunctivalization.
  
  
  RESULTS
  On average, 286 report cards were sent by the Surveillance Unit to practising ophthalmologists each month (total 3429 over 12 months) and the Unit received an average of 176 responses per month (total 2111; 62% response rate). During the 1-year study period from April 2013 to March 2014, 14 positive cases were reported to the Unit. A range of underlying aetiologies were implicated, with contact lens over-wear and cicatrizing conjunctivitis being the most common (n = 3).
  
  
  CONCLUSIONS
  This surveillance study is the first worldwide to document the incidence of limbal stem cell deficiency; however, because of study design limitations, it is likely to have been under-reported. It provides novel data on the demographics, clinical conditions and management of patients with limbal stem cell deficiency as reported by treating ophthalmologists.
authors: Prince of Wales Clinical School, University of New South Wales, Sydney, New South Wales, Australia.
authors: Samantha
authors: S
authors: Bobba
authors: School of Medical Sciences, University of New South Wales, Sydney, New South Wales, Australia.
authors: Nick
authors: N
authors: Di Girolamo
authors: Flinders University of South Australia, Adelaide, South Australia, Australia.
authors: Richard
authors: R
authors: Mills
authors: University of Melbourne, Melbourne, Victoria, Australia.
authors: Mark
authors: M
authors: Daniell
authors: Royal Victorian Ear and Eye Hospital, Melbourne, Victoria, Australia.
authors: Elsie
authors: E
authors: Chan
authors: School of Biomedical Sciences, Queensland University of Technology, Brisbane, Queensland, Australia.|Queensland Eye Institute, South Brisbane, Queensland, Australia.
authors: Damien G
authors: DG
authors: Harkin
authors: Queensland Eye Institute, South Brisbane, Queensland, Australia.
authors: Brendan G
authors: BG
authors: Cronin
authors: Centre for Ophthalmology and Visual Science, University of Western Australia, Perth, Western Australia, Australia.|Lions Eye Institute, Perth, Western Australia, Australia.
authors: Geoffrey
authors: G
authors: Crawford
authors: Department of Ophthalmology, New Zealand National Eye Centre, University of Auckland, Auckland, New Zealand.
authors: Charles
authors: C
authors: McGhee
authors: Prince of Wales Clinical School, University of New South Wales, Sydney, New South Wales, Australia.|Save Sight Institute, University of Sydney, Sydney, New South Wales, Australia.|Sydney Eye Hospital, Sydney, New South Wales, Australia.
authors: Stephanie
authors: S
authors: Watson
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001315:Australia / Q000453:epidemiology; D003316:Corneal Diseases / Q000453:epidemiology* / Q000473:pathology / Q000601:surgery; D019573:Epithelium, Corneal / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D016850:Limbus Corneae / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009520:New Zealand / Q000453:epidemiology; D010865:Pilot Projects; D011159:Population Surveillance / Q000379:methods*; D012720:Severity of Illness Index; D033581:Stem Cell Transplantation; D013234:Stem Cells / Q000473:pathology*; D013997:Time Factors; D014792:Visual Acuity; D055815:Young Adult
keywords: epidemiology; eye diseases; stem cells