Ophthalmology Department, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
Academic Unit of Ophthalmology, Institute of Inflammation and Ageing, University of Birmingham, College of Medical and Dental Sciences, Birmingham, UK.
Syst Rev. 2019 Jan 22;8(1):30. doi: 10.1186/s13643-019-0946-3.
Uveitis describes a group of inflammatory conditions affecting the eye. The ability to monitor inflammatory changes in anterior uveitis is crucial in clinical practice for making treatment decisions and in clinical trials for testing therapeutic agents. The current standard for quantifying anterior segment inflammation is clinical slit-lamp examination findings classified using the Standardisation of Uveitis Nomenclature (SUN) grading system. Such clinical grading systems rely on a subjective estimation using the slit lamp and are often non-linear and non-continuous scales, with large increases in cell count between each grade. Novel instrument-based technologies have emerged over the last few decades, which can provide objective and quantifiable measurements. This review will evaluate the reliability of such technologies and their level of agreement with anterior chamber (AC) cell count using clinical slit-lamp examination.
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 AC cells. 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 correlation of index test measurements of AC cells with clinical grading systems using slit-lamp examination and the reliability of each index test identified. Quality assessment will be undertaken using QUADAS2. Degree of correlation between the index and reference test measures will be pooled and meta-analysed if appropriate.
A number of instrument-based tools are available for measuring AC cells. This review will evaluate the technologies available and measure the level of correlation of these alternative methods with clinical grading systems as well as their performance in reliability and repeatability. The findings of this review will identify those objective, instrument-based technologies which show good utility for measuring AC cells in a quantifiable way and which warrant further exploration for their sensitivity and reliability over the current standard.
PROSPERO CRD42017084156 (Liu X, Moore DJ, Denniston AK). Instrument-based tests for measuring anterior chamber (AC) cells in uveitis: a systematic review. 2017). Study screening stage is complete. Data extraction stage has not yet commenced.
葡萄膜炎是一组影响眼睛的炎症性疾病。在临床实践中，监测前葡萄膜炎的炎症变化对于做出治疗决策以及在临床试验中测试治疗药物至关重要。目前，定量前节炎症的标准是使用标准葡萄膜炎命名法（SUN）分级系统对临床裂隙灯检查结果进行分类。这种临床分级系统依赖于裂隙灯的主观估计，通常是非线性和非连续的，每个等级之间细胞计数都会有较大的增加。过去几十年出现了一些基于新型仪器的技术，可以提供客观和可量化的测量。本综述将评估这些技术的可靠性及其与临床前房（AC）细胞计数检查的一致性。
标准系统综述方法将用于识别、选择和提取报告使用任何基于仪器的技术评估 AC 细胞的研究的数据。将通过文献数据库（MEDLINE、EMBASE 和 Cochrane 图书馆）、临床试验注册处和灰色文献进行搜索。不会对语言或出版年份进行限制。感兴趣的结果是使用裂隙灯检查评估 AC 细胞的指标测试测量与临床分级系统的相关性，以及确定的每个指标测试的可靠性。将使用 QUADAS2 进行质量评估。如果合适，将对指标和参考测试测量之间的相关性进行汇总和荟萃分析。
有许多用于测量 AC 细胞的基于仪器的工具。本综述将评估现有技术，并测量这些替代方法与临床分级系统的相关性，以及它们在可靠性和可重复性方面的表现。本综述的结果将确定那些以定量方式测量 AC 细胞具有良好效用的客观、基于仪器的技术，并进一步探索其在当前标准下的敏感性和可靠性。
PROSPERO CRD42017084156（Liu X，Moore DJ，Denniston AK）。用于测量葡萄膜炎前房（AC）细胞的基于仪器的测试：系统评价。2017 年）。研究筛选阶段已经完成。数据提取阶段尚未开始。
