Previously, no one had established a scoring system to classify limbal stem cell deficiency (LSCD), in part because of a lack of a specific and quantitative diagnostic method for the condition. A recent study has taken up the task and created a clinical scoring system to assess the extent of clinical presentation of LSCD based on the extent of limbal and corneal surface involvement. LSCD was graded as mild, moderate and severe stages based on the clinical scores.

Using the new clinical grading system, the study found that central corneal basal epithelial cell density was significantly decreased in eyes with more severe stages of LSCD. The basal epithelial cell density decreased by 23.0%, 40.4% and 69.5% in the mild, moderate, and severe stages, respectively.

Researchers propose that clinical presentation of LSCD alone is not sufficient to quantify the degree of LSCD. A new classification system that combines the clinical scores and basal epithelial cell density reduction scores may more accurately quantify the severity of LSCD or limbal stem cell function. To aid in the assessment of mild LSCD in patients, other parameters such as cell morphology, epithelial thickness and subbasal nerve density are also likely necessary.

Aravena C, Bozkurt K, Chuephanich P, et al. Classification of limbal stem cell deficiency using clinical and confocal grading. Cornea. 2019;38(1):1-7.