Corneal Staining CCLRU Image Analysis We fixed the

Corneal Staining CCLRU Image Analysis We fixed the corneal diameter length (~12 mm) as marker and we distinguished the different types of corneal staining by using this classification -Micropunctate : Area ≤ 0. 002 mm 2 -Macropunctate: 0. 002 ≤ Area ≤ 0. 01 mm 2 -Coalescent macropunctate: 0. 01 ≤ Area ≤ 0. 3 mm 2 -Patch: Area >0. 3 mm 2 The analysis has been carried out only on the zones with clinical relevance and not on the whole corneal area.

Corneal Staining CCLRU 1 Image analysis

Results Corneal tot Micropunctate Macropunctate 107 88 25 Area involved 0. 135 by staining (mm 2) 0. 069 0. 078 % Area involved by staining 0. 097% 0. 11% N° of counts 0. 2% The corneal area is ~71 mm 2

Corneal Staining CCLRU 2 Image analysis

Analisi sulla zona 1 Micropunctate Macropunctate Coalescent macropunctate

Results Zona 1 tot Micropunctate Macropunctate Coalescent Macropunctate 112 70 43 3 Area involved 0. 464 by staining (mm 2) 0. 058 0. 283 0. 132 % Area involved by staining 0. 4% 1. 8% 0. 85% N° of counts 3% The area of zone 1 is ~15. 5 mm 2

Corneal Staining CCLRU 3 Image analysis

Results Zona 4 tot Micropunctate Macropunctate Agglomerate 140 94 43 11 Area involved 0. 600 by staining (mm 2) 0. 094 0. 203 0. 329 % Area involved by staining 0. 5% 1% 1. 7% N° of counts 3. 1% The area of zone 4 is ~19. 3 mm 2

Corneal Staining CCLRU 4 Image analysis

Results Zona 2 Tot Micro. Punt Macro. Punt Coal. Macr. Patch N° of counts 149 83 62 10 1 Area involved by staining (mm 2) 4. 849 0. 079 0. 276 0. 223 4. 295 % Area involved by staining 22 0. 35 1. 2 1 19. 3 The area of zone 2 is ~ 22. 2 mm 2

CCLRU standard for corneal staining with fluorescein

Discussion We propose a “modified CCLRU standard” 1 Five zone as in the CCLRU standard 2 Type: 5 Grades (from 0 to 4) 3 No depth standard modification since we didn’t make analysis concerning this aspect (up to now) 4 Extent: 5 grades (from 0 to 4) but We propose a new classification: 0 = absent (o < 1%) 1 = from 1% to 3% surface involvement 2 = from 3% to 10% surface involvement 3 = from 10% to 30% surface involvement 4 = >30 % surface involvement