September 2016
Volume 57, Issue 12
Open Access
ARVO Annual Meeting Abstract  |   September 2016
DELTA Scoring System: A Novel method for clinical grading of corneal neovascularization
Author Affiliations & Notes
  • SUNEEL Gupta
    Harry S. Truman Memorial Veteran Hospital , Columbia, Missouri, United States
    Veterinary Medicine & Surgery, University of Missouri, Columbia, Missouri, United States
  • Michael K Fink
    Harry S. Truman Memorial Veteran Hospital , Columbia, Missouri, United States
    Veterinary Medicine & Surgery and Veterinary Pathology, University of Missouri, Columbia, Missouri, United States
  • Prashant Rajiv Sinha
    Harry S. Truman Memorial Veteran Hospital , Columbia, Missouri, United States
    Veterinary Medicine & Surgery, University of Missouri, Columbia, Missouri, United States
  • Rajiv R Mohan
    Harry S. Truman Memorial Veteran Hospital , Columbia, Missouri, United States
    Veterinary Medicine & Surgery, Biomedical Sciences, Veterinary Pathology and Mason Eye Institute, University of Missouri, Columbia, Missouri, United States
  • Footnotes
    Commercial Relationships   SUNEEL Gupta, None; Michael Fink, None; Prashant Sinha, None; Rajiv Mohan, None
  • Footnotes
    Support  The Ruth M. Kraeuchi Missouri Endowment Chair Ophthalmology Fund. Partially from the RO1EY17294 National Eye Institute, NIH, Bethesda, Maryland, USA and 1I01BX00035701 Veteran Health Affairs, Washington DC USA grants.
Investigative Ophthalmology & Visual Science September 2016, Vol.57, 3527. doi:
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    • Get Citation

      SUNEEL Gupta, Michael K Fink, Prashant Rajiv Sinha, Rajiv R Mohan; DELTA Scoring System: A Novel method for clinical grading of corneal neovascularization. Invest. Ophthalmol. Vis. Sci. 2016;57(12):3527.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : Corneal neovascularization (CNV) is a vision-threatening condition stemming from a variety of corneal insults affecting 1.4 million people worldwide annually. At present, no standard method exists that represents clinical CNV grading observed in patients. We sought to develop a standardized DELTA grading system representing clinical CNV levels in vivo using a mouse model.

Methods : Seventy C57BL/6 mice of either sex were used as approved under IACUC protocol. CNV was produced via single topical application of a filter-paper disc (2mm) saturated with 10µl alkali (0.5N sodium hydroxide) on the central cornea for 30 seconds. This initiated sprouting of blood vessels towards cornea on day-14 and peaked on day-35. CNV formation, progression, levels, density, and localization were monitored using slit- and stereomicroscopy at various times. Collected eyes were serially sectioned and subjected to H&E and immunofluorescence. Corneal flat mounts were stained with lectin. The CNV quantification and grading was performed with NIH Image, Adobe Photoshop, and Microsoft Excel by three individuals in a blinded manner.

Results : DELTA grading was developed by measuring Density of vasculature (D), Enlargement of vasculature (E), Length of vasculature (L), Thickness of vasculature (T), and Area of vasculature (A) in 4 quadrants of each cornea. Topical alkali initiated CNV on day-14 that peaked at day-35. DELTA parameters in each quadrant of the cornea were measured from day 0-35. DELTA score was assigned based on CNV severity and affected area of the cornea:
Grade 0: no CNV with DELTA score 0;
Grade 1: low CNV with DELTA score 1-5 (20-30 % cornea affected);
Grade 2: moderate CNV with DELTA score 5-10 (30-50 % cornea affected);
Grade 3: severe CNV with DELTA score 11-15 (50-70 % cornea affected);
Grade 4: very severe CNV with DELTA score 16-20 (70-90 % cornea affected).

Conclusions : A newly defined CNV DELTA grading system represents realistic clinical condition as seen in human patients. This novel method is useful for advancing bench-to-bedside translational research and identifying novel therapies for CNV.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.

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