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. Author manuscript; available in PMC: 2024 Jul 1.
Published in final edited form as: Surv Ophthalmol. 2023 Mar 2;68(4):697–712. doi: 10.1016/j.survophthal.2023.02.006

Table 4:

Ocular GVHD diagnostic criteria and grading scale according to the NIH criteria (2014) and Ocular GVHD diagnostic criteria and grading scale according to the International Consensus Criteria on chronic ocular graft- versus- host disease (ICCGVHD)

A. Ocular GVHD diagnostic criteria and grading scale according to the NIH criteria (2014)
Severity Grade Score 0 Score 1 Score 2 Score 3
Symptoms KCS confirmed by an ophthalmologist in the absence of symptoms, the requirement of eye drops or ADL Mild Moderate Severe
The requirement of lubricant eye drops ≤3 times/day >3 times/day or punctal plug Special eyewear required to relieve pain
ADL impairment Not affected Partially affected without new vision impairment due to KCS Significantly affected or unable to work or loss of vision due to KCS
B. Ocular GVHD diagnostic criteria and grading scale according to the International Consensus Criteria on chronic ocular graft-versus-host disease (ICCGVHD)
Diagnosis None (points) Probable ocular GVHD (points) Definite ocular GVHD (points)
Systemic GVHD (−) 0–5 6–7 ≥8
Systemic GVHD (+) 0–3 4–5 ≥6
Severity scale Schirmer test (mm) CFS (points) OSDI (points) Conjunctival injection
0 >15 0 (No staining) <13 None
1 11–15 <2 (Minimal Staining) 13–22 Mild/Moderate
2 6–10 2–3 (Mild-moderate staining) 23–32 Severe
3 ≤5 >4 (Severe staining) ≥33 -
oGVHD disease severity None Mild-Moderate Severe
The total score is obtained by adding the severity score for Schirmer test + CFS + OSDI + conjunctival injection 0–4 5–8 9–11

(KCS, keratoconjunctivitis sicca; ADL, activities of daily living; CFS, corneal fluorescein staining; OSDI, ocular surface disease index)