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

Thomas W McNally; Xiaoxuan Liu; Sophie Beese; Pearse A Keane; David J Moore; Alastair K Denniston

doi:10.1186/s13643-019-1206-2

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

Thomas W McNally, Xiaoxuan Liu, Sophie Beese, Pearse A Keane, David J Moore, Alastair K Denniston

Research output: Contribution to journal › Article › peer-review

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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.

Original language	English
Article number	287
Journal	Systematic Reviews
Volume	8
Issue number	1
DOIs	https://doi.org/10.1186/s13643-019-1206-2
Publication status	Published - 26 Nov 2019

Bibliographical note

Publisher Copyright:
© 2019 The Author(s).

Keywords

Systematic review
Uveitis
Anterior chamber flare
Intraocular inflammation
Aqueous humour
Proteins
Blood-ocular barrier
Monitoring test
Diagnostic test
Optical coherence tomography
Laser flare photometry
Laser flare meter
Tyndallometry

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Cite this

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

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.",

keywords = "Systematic review, Uveitis, Anterior chamber flare, Intraocular inflammation, Aqueous humour, Proteins, Blood-ocular barrier, Monitoring test, Diagnostic test, Optical coherence tomography, Laser flare photometry, Laser flare meter, Tyndallometry",

author = "McNally, {Thomas W} and Xiaoxuan Liu and Sophie Beese and Keane, {Pearse A} and Moore, {David J} and Denniston, {Alastair K}",

note = "Publisher Copyright: {\textcopyright} 2019 The Author(s).",

year = "2019",

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doi = "10.1186/s13643-019-1206-2",

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AB - 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.

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KW - Optical coherence tomography

KW - Laser flare photometry

KW - Laser flare meter

KW - Tyndallometry

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JO - Systematic Reviews

JF - Systematic Reviews

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ER -

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

Abstract

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Keywords

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