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Ocular Immunology and Inflammation Volume 29, 2021 - Issue 5
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Original Article

Non-invasive Instrument-Based Tests for Quantifying Anterior Chamber Flare in Uveitis: A Systematic Review

Xiaoxuan Liua Ophthalmology Department, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK;b Academic Unit of Ophthalmology, Institute of Inflammation & Ageing, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UKORCID Iconhttps://orcid.org/0000-0002-1286-0038
, MBChBORCID Icon,
Thomas W. McNallyb Academic Unit of Ophthalmology, Institute of Inflammation & Ageing, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
,
Sophie Beesec Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
, MPH,
Laura E. Downied Department of Optometry and Vision Sciences, The University of Melbourne, Parkville, AustraliaORCID Iconhttps://orcid.org/0000-0002-1596-2259
, PhDORCID Icon,
Ameenat L. Soleboe Institute of Child Health, University College London, London, UK
, PhD,
Livia Faesf NIHR Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK;g Eye Clinic, Cantonal Hospital of Lucerne, Lucerne, Switzerland
, MD,
Syed Husainb Academic Unit of Ophthalmology, Institute of Inflammation & Ageing, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
,
Pearse A. Keanef NIHR Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK;h Health Data Research UK, London, UK
, MD,
David J. Moorec Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
, PhD &
Alastair K. Dennistona Ophthalmology Department, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK;b Academic Unit of Ophthalmology, Institute of Inflammation & Ageing, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK;f NIHR Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK;h Health Data Research UK, London, UKCorrespondence[email protected]
ORCID Iconhttps://orcid.org/0000-0001-7849-0087
, PhDORCID Icon show all
Pages 982-990 | Received 04 Oct 2019, Accepted 23 Dec 2019, Published online: 07 Apr 2020
 
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ABSTRACT

Purpose: Anterior chamber (AC) flare is a key sign for anterior uveitis. New instrument-based techniques for measuring AC flare can offer automation and objectivity. This review aims to identify objective instrument-based measures for AC flare.

Methods: In this systematic review, we identified studies reporting correlation between instrument-based tests versus clinician AC flare grading, and/or aqueous protein concentration, as well as test reliability.

Results: Four index tests were identified in 11 studies: laser-flare photometry (LFP), optical coherence tomography, ocular flare analysis meter (OFAM) and the double-pass technique. The correlation between LFP and clinician grading was 0.40–0.93 and 0.87–0.94 for LFP and protein concentration. The double-pass technique showed no correlation with clinician grading and insufficient information was available for OFAM.

Conclusion: LFP shows moderate to strong correlation with clinician grading and aqueous protein concentration. LFP could be a superior reference test compared to clinician AC flare grading for validating new index tests.

Declaration of interest

AKD and PAK receive a proportion of their funding from the Department of Health’s NIHR Biomedical Research Centre for Ophthalmology at Moorfields Eye Hospital and UCL Institute of Ophthalmology. XL and AKD receive a proportion of their funding from the Wellcome Trust, through a Health Improvement Challenge grant (200141/Z/15/Z). ALS is supported by an NIHR Clinician Scientist award (CS-2018-18-ST2-005). LED has no disclosures relating directly to this work. She has received research funding from Allergan Pty Ltd, Alcon Pty Ltd, and Azura Ophthalmics, and consulting income from Seqirus and Medmont International, outside of this work.

Author contributions

XL: lead reviewer, manuscript drafting, manuscript reviewing. TWM: second reviewer, data extraction manuscript drafting, manuscript reviewing. SB: data extraction, manuscript drafting, manuscript reviewing. LF, LED, ALS, SH: manuscript drafting, manuscript reviewing. PAK, DJM, AKD project conception, supervision, manuscript reviewing.

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