Defining Ocular Surface Disease Activity and Damage Indices by an International Delphi Consultation

P.A. Mathewson, G.P. Williams, S.L. Watson, J. Hodson, A. Bron, S. Rauz, S. Ahmad, A. Bron, M. Burton, J.K. Dart, F. Figueiredo, G. Geerling, N. Hawksworth, D. Jacobs, S. Kaye, S.S. Kolli, D.F. Larkin, S. Mantry, P.I. Murray, C. Liu & 4 others A. Shortt, P.J. Tomlins, D. Verity, C. Willoughby

    Research output: Contribution to journalArticle

    4 Citations (Scopus)

    Abstract

    Unifying terminology for the description of ocular surface disease (OSD) is vital for determining treatment responses and ensuring robust clinical trial outcomes. To date, there are no agreed parameters describing ‘activity’ and ‘damage’ phases of disease.

    A working group of international experts in OSD, oculoplastics, and uveitis from a range of backgrounds (university, teaching, district general and private hospitals) participated in a modified Delphi consensus-building exercise (October 31, 2011 to March 20, 2015). Two steering group meetings took place in which factors based upon published literature were discussed and supplemented with anonymous web-based questionnaires to refine clinical indices according to ‘activity’ (reversible changes resulting directly from the inflammatory process) and/or ‘damage’ (persistent, >6 months duration) changes resulting from previously active disease that are cumulative and irreversible).

    The recommended set of clinical parameters for the assessment of OSD encompasses 68 clinical indices and 22 ancillary grading tools (in parenthesis) subdivided by anatomical domain as follows: 4(4) tear-film, eyelid 21(3), 17(3) conjunctiva, 15(10) cornea and 11(2) Anterior Chamber/Sclera. Of these; 17(2) were considered as measures of clinical activity, 27(3) as damage, 1(8) as measures of both activity and damage. Twenty-three clinical descriptors and 9 tools did not reach the threshold for inclusion into the main standard set. These were defined as ‘second tier’ parameters for use in special clinical settings.

    These core parameters provide the first description of ‘activity’ and ‘damage’ relevant to OSD and provide a platform for the future development of scoring scales for each parameter.

    LanguageEnglish
    Pages97-111
    Number of pages15
    JournalThe Ocular Surface
    Volume15
    Issue number1
    Early online date25 Sep 2016
    DOIs
    Publication statusPublished - Jan 2017

    Fingerprint

    Eye Diseases
    Referral and Consultation
    Private Hospitals
    Sclera
    Group Processes
    District Hospitals
    Conjunctiva
    Uveitis
    Anterior Chamber
    Eyelids
    Tears
    Terminology
    General Hospitals
    Cornea
    Consensus
    Teaching
    Clinical Trials

    Keywords

    • cornea
    • conjunctiva
    • Delphi process
    • disease activity
    • disease damage
    • disease scoring
    • disease staging
    • ocular surface disease

    Cite this

    Mathewson, P.A. ; Williams, G.P. ; Watson, S.L. ; Hodson, J. ; Bron, A. ; Rauz, S. ; Ahmad, S. ; Bron, A. ; Burton, M. ; Dart, J.K. ; Figueiredo, F. ; Geerling, G. ; Hawksworth, N. ; Jacobs, D. ; Kaye, S. ; Kolli, S.S. ; Larkin, D.F. ; Mantry, S. ; Murray, P.I. ; Liu, C. ; Shortt, A. ; Tomlins, P.J. ; Verity, D. ; Willoughby, C. / Defining Ocular Surface Disease Activity and Damage Indices by an International Delphi Consultation. In: The Ocular Surface. 2017 ; Vol. 15, No. 1. pp. 97-111.
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    Mathewson, PA, Williams, GP, Watson, SL, Hodson, J, Bron, A, Rauz, S, Ahmad, S, Bron, A, Burton, M, Dart, JK, Figueiredo, F, Geerling, G, Hawksworth, N, Jacobs, D, Kaye, S, Kolli, SS, Larkin, DF, Mantry, S, Murray, PI, Liu, C, Shortt, A, Tomlins, PJ, Verity, D & Willoughby, C 2017, 'Defining Ocular Surface Disease Activity and Damage Indices by an International Delphi Consultation', The Ocular Surface, vol. 15, no. 1, pp. 97-111. https://doi.org/10.1016/j.jtos.2016.08.005

    Defining Ocular Surface Disease Activity and Damage Indices by an International Delphi Consultation. / Mathewson, P.A.; Williams, G.P.; Watson, S.L.; Hodson, J.; Bron, A.; Rauz, S.; Ahmad, S.; Bron, A.; Burton, M.; Dart, J.K.; Figueiredo, F.; Geerling, G.; Hawksworth, N.; Jacobs, D.; Kaye, S.; Kolli, S.S.; Larkin, D.F.; Mantry, S.; Murray, P.I.; Liu, C.; Shortt, A.; Tomlins, P.J.; Verity, D.; Willoughby, C.

    In: The Ocular Surface, Vol. 15, No. 1, 01.2017, p. 97-111.

    Research output: Contribution to journalArticle

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