Abstract-Text (inkl. Referenzen)

Purpose: Corneal confocal microscopy (CCM) is a non-invasive imaging technique to analyse corneal nerve fibres and corneal inflammatory cells (CIC). The amount of CICs are a possible biomarker of disease activity in chronic autoinflammatory diseases (Motte et al. 2021). However, no standardized criteria for the morphological differentiation of CICs exist. The aim of this work was to create a protocol for a standardized morphological classification and to test this protocol on its applicability and reliability. Method: The development of the protocol was a two-step process. Initially, based on literature research, the existing morphological descriptions of CICs were transferred into a structured algorithm and applied by naïve raters. Based on these results the protocol was optimized, and the second version was applied again by different raters. Interrater reliability (IRR) was calculated with Fleiss kappa (K). Results: The first protocol achieved only a slight agreement within three raters (K= 0,09). For the revised protocol, substantial agreement was achieved with three (K= 0,64) and four (K=0,61) raters. Conclusion: The assessment first protocol showed that the criteria currently in use cannot be applied in a standardised way. The suggested new protocol as proposed enables reproducible results also for inexperienced raters and thus good applicability for everyday clinical practice. Thus, subtypes of inflammation can be differentiated and a comparability of labs can be made.