Br J Ophthalmol 1999;83:1159-1163
( October )
Grading nuclear cataract: reproducibility and validity of a new
method
Nigel F Halla, Philip Lempertb, Rosaleen P Shiera, Rahila Zakirc, David Phillipsa
a Medical Research
Council Environmental Epidemiology Unit (University of Southampton),
Southampton General Hospital, Southampton, b Department of
Physiology, School of Veterinary Medicine, Cornell University, Ithaca,
NY, USA, c Southampton Eye Unit,
Southampton General Hospital, Southampton
Correspondence to: Dr Nigel F Hall, MRC Environmental
Epidemiology Unit, (University of Southampton), Southampton General
Hospital, Tremona Road, Southampton SO16 6YD.
Accepted for publication 25 June 1999
AIMS To assess the
reproducibility and validity of a new instrument for grading nuclear
cataractthe laser slit lamp, by comparison with an established method
of lens gradingthe Lens Opacities Classification System III (LOCS III).
METHODS62 volunteers
(113 eyes) were examined on two occasions. At each visit, a video image
of the anterior segment was captured with the laser slit lamp and
stored digitally. A measure of lens opacity for each laser slit lamp
image was calculated using image analysis software. Each lens was also
photographed on both visits for LOCS III grading of nuclear colour and
nuclear opalescence.
RESULTSThere was a
linear increasing relation between the laser slit lamp measure of
nuclear lens opacity and the LOCS III nuclear opalescence scores. The
overall reproducibility of the laser slit lamp measurement was
comparable with LOCS III (intraclass correlation coefficient of 95%
(95% CI 92.9-96.5) for the laser slit lamp method; 97% (95% CI
95.6-97.9) for the LOCS III method). However, among healthy subjects,
the reproducibility was lower (intraclass correlation for the laser
slit lamp of 38.6% (95% CI 12.9-59.2) and 76.1% (95% CI
62.3-85.4) for LOCS III.
CONCLUSIONThe laser
slit lamp appears to give a valid measurement of nuclear cataract. The
reproducibility of the instrument was high and similar to that of LOCS
III. Modifications to the design would have to be made to improve its
reproducibility among healthy subjects. It is simpler than other
objective instruments, and could be useful in large scale studies of cataract.
© 1999 by British Journal of Ophthalmology
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