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The Oxford Clinical Cataract Classification and Grading System

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Abstract

A composite slit-lamp based system for the clinical classification and grading of cataract is described. Cataract features are classified morphologically, and individual features are graded by comparison with standard diagrams mounted adjacent to the slit-lamp. Attention has been paid to relevant aspects of measurement theory, with equal interval steps between the grades. The image degrading effect of the cataract is assessed using a ‘resolution target projection ophthalmoscope’. The method may be used in conjunction with photographic and image analysing techniques.

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References

  1. Berliner ML: Biomicroscopy of the Eye. Vol 2. p 1115. Medical Book Department, Harper and Brothers, New York, 1949

    Google Scholar 

  2. Bron AJ, Brown NAP: Classification, grading and prevention of cataract. IBID 4(1): 21–47, 1983

    Google Scholar 

  3. Bron AJ, Brown N: Retro-dots. In preparation

  4. Brown N: Slit image photography. Trans Ophthal Soc UK 89: 397–408, 1968

    Google Scholar 

  5. Brown N: Quantitative slit image photography of the lens. Trans Ophthal Soc UK 92: 303–317, 1972

    Google Scholar 

  6. Brown N: Visibility of transparent objects in the eye by retro-illumination. Brit J Ophthalmol 55: 517–524, 1971

    Google Scholar 

  7. Brown N: An advanced slit-image camera. Trans Ophthal Soc UK 56: 624–631, 1972

    Google Scholar 

  8. Brown N: Lens change with age and cataract; slit image photography. (General discussion 1.) In: The human lens in relation to cataract. CIBA Found. symp. 19 (Ed: Elliott K, Fitzsimons DW) p 65–78, 1973

  9. Brown NAP, Bailey K, Ayliffe W, Sparrow JM, Bron AJ: Photographic evaluation of cataract. In preparation, presented at the CCRG meeting, Hawaii. (December 1985)

  10. Brown N, Gardner RJM: Lowe Syndrome: Identification of the carrier state. In: The eye and inborn errors of metabolism. (Ed: Bergsma D, Bron AJ, Cotlier E) p 579–591, 1976

  11. Brown N, Tripathi R: The loss of the anterior sub-capsular clear zone of the lens. Prognostic significance in cataract formation. Trans Ophthal Soc UK 94: 29–45, 1984

    Google Scholar 

  12. Cicchetti DV, Sharma Y, Cotlier E: Assessment of observer variability in the classification of human cataracts. The Yale J of Biol and Med 55: 81–88, 1982

    Google Scholar 

  13. Chylack LT: Classification of human cataracts. Arch Ophthalmol 96: 888–892, 1978

    Google Scholar 

  14. Chylack LT, Editorial: The co-operative cataract research group. Invest Ophthalmol 17(12): 1131–34, 1978

    Google Scholar 

  15. Chylack LT: Classification of human cataractous change by the American co-operative cataract research group method. In: Human cataract formation. (Ed: Nugent J, Whelan J.) Pitman, London. (CIBA Foundation Symposium, 106.) p: 3–24, 1984

    Google Scholar 

  16. Chylack LT, Cheng HM, White O: Retro-illumination and Topcon SL-45 photography of cataracts in vivo: A Quantatative study of the variences of these techniques with computerized image analysis. ARVO Abst Sarasota suppl, Invest Ophthalmol 25: 270, 1984

    Google Scholar 

  17. Chylack LT, Lee MR, Tung WH, Cheng HM: Classification of human senile cataractous change by the American co-operative cataract research group method. 1. Instrumentation and technique. Invest Ophthalmol 24: 424–431, 1983

    Google Scholar 

  18. Chylack LT, Ransil BJ, White O: Classification of human senile cataractous change by the American co-operative cataract research group method. 3. The association of nuclear colour (sclerosis) with extent of cataract formation, age and visual acuity. Invest Ophthalmol 25: 174–180, 1984

    Google Scholar 

  19. Chylack LT, White O, Tung WH: Classification of human cataractous change by the American co-operative cataract research group method. 2. Staged simplification of cataract classification. Invest Ophthalmol 25: 166–173, 1984

    Google Scholar 

  20. Clayton RM, Cuthbert J, Phillips CI, Bartholomew RS, Stokoe NL, Ffytche T, McK Reid J, Duffy J, Seth J, Alexander M: Analysis of individual cataract patients and their lenses: A progress report. Exp Eye Res 31: 553–566, 1980

    Google Scholar 

  21. Cotlier E: Senile cataracts: Evidence for acceleration by diabetes and deccleration by salicylate. Can J Ophthalmol 16: 113–118, 1981

    Google Scholar 

  22. Cotlier E, Fagadau W, Cicchetti DV: Methods for evaluation of medical therapy of senile and diabetic cataracts. Trans Ophthal Soc UK 102: 416–422, 1982

    Google Scholar 

  23. Crews SJ: Posterior subcapsular lens opacities in patients on long term corticosteroid therapy. Brit Med J (22nd June): 1644–46, 1963

  24. Cuthbert J, Clayton RM, Truman DES, Phillips CI, Bartholomew RS: Analysis of the crystallin composition of individual human lenses: Characteristic modification associated with different cataracts. Interdiscipl Topics Geront 13: 183–192, 1978

    Google Scholar 

  25. Duke-Elder S: System of Ophthalmology, Vol 2, The anatomy of the visual system. Henry Kimpton, London, p 312, 1960

    Google Scholar 

  26. Duncan G: On classifying human cataractous lenses. In: Mechanisms of cataract formation in the human lens. (Ed: Duncan G) Academic press, London, p 1–5, 1981

    Google Scholar 

  27. Duncan G, Bushell AR: Relationships between colour, sodium and protein content of individual senile human cataractous lenses. Ophthal Res 11: 397–404, 1979

    Google Scholar 

  28. Ederer F, Hiller R, Taylor HR: Senile lens changes and diabetes in two population studies. Am J Ophthalmol 91: 381–395, 1981

    Google Scholar 

  29. Fincham EF: Photographic recording of opacities of the ocular media. Brit J Ophthalmol 39: 85–89, 1955

    Google Scholar 

  30. Goldman H, Niesel P: Ophthalmologica 147: 134, 1964

    Google Scholar 

  31. Harding JJ: Changes in lens proteins in cataract, In: Molecular and cellular biology of the eye lens. (Ed: Bloemendal H) John Wiley, New York p 327–365, 1981

    Google Scholar 

  32. Helve J, Nieminen H: Autofluorescence of the human diabetic lens in vivo. Am J Ophthalmol 81: 491–494, 1976

    Google Scholar 

  33. Hockwin O, Dragomirescu V: Die Scheimpflug-photographie des vorderen augenabschnittes. Z prakt Augenheilkd 2: 129–136, 1981

    Google Scholar 

  34. Hockwin O, Dragomirescu V, Koch HR: Photographic documentation of disturbances of the lens transparency during ageing, with a Scheimpflug camera system. Ophthal Res 11: 405–410, 1979

    Google Scholar 

  35. Hockwin O, Dragomirescu V, Laser H: Measurements of lens transparency or its disturbances by densitometric image analysis of Scheimpflug photographs. Graefe's Arch Clin Exp Ophthalmol 219: 255–262, 1982

    Google Scholar 

  36. Hockwin O, Eckerskorn U, Schmidtmann W, Dragomirescu V, Korte I, Laser H: Epidemiological study of the association between lens cataract and case history, blood composition, and enzymes involved in lens carbohydrate metabolism. Lens Res 2(1): 23–41, 1984

    Google Scholar 

  37. Hockwin O, Lerman S, Ohrloff C: Investigations on lens transparency and its disturbances by micro-densitometric analysis of Scheimpflug photographs. Curr Eye Res 3(1): 15–22, 1984

    Google Scholar 

  38. Hockwin O, Weigelin E, Laser H, Dragomirescu V: Biometry of the anterior eye segment by Scheimpflug photography. Ophthalmic Res 15: 102–108, 1983

    Google Scholar 

  39. Kahn HA, Leibowitz H, Ganley PJ, Kini M, Colton T, Nickerson R, Dawber TR: Standardizing diagnostic proceedures. Am J Ophthalmol 79(5): 768–775, 1975

    Google Scholar 

  40. Kahn HA, Leibowitz HM, Ganley JP, Kini MM, Colton T, Nickerson RS, Dawber TR: The Framingham Eye Study. 1. Outline and major prevalence findings. Am J Epidemiol 106(1): 17–32, 1977

    Google Scholar 

  41. Kawara T, Obazawa H: A new method for retroillumination photography of cataractous lens opacities. Am J Ophthalmol 90: 186–189, 1980

    Google Scholar 

  42. Kawara T, Obazawa H, Nakano R, Sasaki M, Sakata T: Quantatative evaluation of cataractous lens opacities with retro-illumination photography. Jpn J Ophthalmol (Rinsho Ganka.) 33: 21–26, 1979

    Google Scholar 

  43. Koch HR, Schnell G: Intrinsic yellow fluorescence of human lenses. Ophthal Res Suppl 16: 209, 1984

    Google Scholar 

  44. Leibowitz H, Bussey T, McGuire P: Shape and size constancy in photographic reproductions. J Opt Soc Amer 47: 658–661, 1957

    Google Scholar 

  45. Leibowitz HM, Krueger DE, Maunder LR, Milton RC, Kini MM, Kahn HA, Nickerson RJ, Pool J, Colton TL, Ganley JP, Lowenstein JI, Dawber TR: The Framingham Eye Study. Monograph Surv Ophthalmol Suppl 24: 350–364, 1980

    Google Scholar 

  46. Lerman S: An experimental and clinical evaluation of lens transparency and ageing. J Geront 38: 293–301, 1983

    Google Scholar 

  47. Lerman S, Hockwin O: Ultraviolet-visible slit lamp densitography of the human eye. Exp Eye Res 33: 587–596, 1981

    Google Scholar 

  48. Leske MC, Sperduto RD: Epidemiology of senile cataracts: A review. Am J Epidemiol 118(2): 152–165, 1983

    Google Scholar 

  49. Maclean H, Taylor CJ: An objective staging for cortical cataract in vivo aided by pattern-analysing computer. Exp Eye Res 33: 597–602, 1981

    Google Scholar 

  50. Marcantonio JM, Duncan G, Davies PD, Bushell AR: Classification of human senile cataracts by nuclear colour and sodium content. Exp Eye Res 31: 227–237, 1980

    Google Scholar 

  51. Munsell Colour, Macbeth Division of Kollmorgen Corporation, 2441 N. Calvert street, Baltimore, Maryland. 21218

  52. Newhall SM, Nickerson D, Judd DB: Final report of the O.S.A. Subcommittee on the spacing of the Munsell colours. J Opt Soc Am 33: 385–418, 1943

    Google Scholar 

  53. Niesel P: Visible changes of the lens with age. Trans Ophthal Soc UK 102: 327–330, 1982

    Google Scholar 

  54. Peckar CO, M.Sc. Thesis, Linacre College, University of Oxford p 46–50, 1982

  55. Pirie A: Colour and solubility of the proteins of human cataracts. Invest Ophthalmol 7(6): 634–650, 1968

    Google Scholar 

  56. Sasaki K, Oishi T, Yamaaki H, Nakamura F: Documentation of human lens by rotating photoslit-lamp. Clinical applications and examinations for the reproducibility of obtained photographs. Jpn J Ophthal 33: 621–627, 1979

    Google Scholar 

  57. Shibata T, Hockwin O, Weigelin E, Kleifeld O, Dragomirescu V: Lens biometry according to age and cataract morphology. Evaluation of Scheimpflug photographs of the anterior segment. Klin Mbl Augenheilk 185: 35–42, 1984

    Google Scholar 

  58. Shibata T, Sasaki K: Observation of ageing changes of lens transparency - Analysis of 541 eyes from colour images. Nippon Ganka Gakkai Zasshi 86: 1701–8, 1982

    Google Scholar 

  59. Sommer A: Cataracts as an epidemiologic problem. Am J Ophthalmol 83(3): 334–339, 1977

    Google Scholar 

  60. Sparrow JM, Aylffe W, Hill A: In preparation

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Sparrow, J.M., Bron, A.J., Brown, N.A.P. et al. The Oxford Clinical Cataract Classification and Grading System. Int Ophthalmol 9, 207–225 (1986). https://doi.org/10.1007/BF00137534

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