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Instrument-based tests for quantifying aqueous humour protein levels in uveitis: a systematic review protocol

McNally, TW; Liu, X; Beese, S; Keane, PA; Moore, DJ; Denniston, AK; (2019) Instrument-based tests for quantifying aqueous humour protein levels in uveitis: a systematic review protocol. Systematic Reviews , 8 , Article 287. 10.1186/s13643-019-1206-2. Green open access

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Abstract

BACKGROUND: Inflammation in anterior uveitis is characterised by breakdown of the blood-ocular barrier, which allows leakage of blood constituents of higher molecular weight into the aqueous humour. In routine clinical care, increase in aqueous protein levels can be observed at the slit lamp as 'flare' and the severity can be graded using various clinical grading systems, of which the Standardization of Uveitis Nomenclature (SUN) grading system is most commonly used. Alternative instrument-based technologies are available, which can detect aqueous protein levels in an objective and quantifiable way. This review will identify instruments capable of measuring anterior chamber inflammation in this way, their level of reliability, and how well the measurements correlate with clinical grading and/or actual aqueous protein concentration. METHODS: Standard systematic review methodology will be used to identify, select and extract data from studies that report the use of any instrument-based technology in the assessment of aqueous protein levels. Searches will be conducted through bibliographic databases (MEDLINE, EMBASE and Cochrane Library), clinical trial registries and the grey literature. No restrictions will be placed on language or year of publication. The outcomes of interest are the level of correlation between identified instrument-based test measurements, clinical grading and/or actual aqueous protein concentration, as well as the reliability of each index test identified. Study quality assessment will be based on QUADAS2. Correlation and reliability outcomes will be pooled and meta-analysed if appropriate. DISCUSSION: The assessment of inflammation in anterior chamber protein levels currently relies on crude and subjective clinical examination. The findings of this review will identify non-invasive technologies which show good correlation with actual protein concentration, which could be used in routine clinical practice for objective monitoring of AC inflammation. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42017084167. Study screening stage has just been completed.

Type: Article
Title: Instrument-based tests for quantifying aqueous humour protein levels in uveitis: a systematic review protocol
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1186/s13643-019-1206-2
Publisher version: https://doi.org/10.1186/s13643-019-1206-2
Language: English
Additional information: This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
Keywords: Anterior chamber flare, Aqueous humour, Blood-ocular barrier, Diagnostic test, Intraocular inflammation, Laser flare meter, Laser flare photometry, Monitoring test, Optical coherence tomography, Proteins, Systematic review, Tyndallometry, Uveitis
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Institute of Ophthalmology
URI: https://discovery.ucl.ac.uk/id/eprint/10087142
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