UVESCREEN1: A randomised feasibility study of imaging-based uveitis screening for children with juvenile idiopathic arthritis- Study Protocol DOI Creative Commons
Sonali Dave, Jugnoo S. Rahi, Harry Petrushkin

et al.

medRxiv (Cold Spring Harbor Laboratory), Journal Year: 2024, Volume and Issue: unknown

Published: Dec. 13, 2024

Abstract Children with Juvenile Idiopathic Arthritis (JIA) are at a currently unpredictable risk of blinding, often asymptomatic, co-existent eye disorder, anterior uveitis which requires prompt treatment. The unpredictability this insidious disorder commits children JIA to three-monthly expert clinical examination in specialist centres located far from their homes. Optical coherence tomography the ocular segment (AS-OCT) has been shown be an acceptable, repeatable and sensitive modality for detection, but is not standard care. This feasibility randomised controlled trial (RCT) aims inform future full-scale RCT comparing current routine practice (expert slit lamp examination, SLE) AS-OCT surveillance risk. Eighty aged between 2 12 years old diagnosed within preceding year will included. Participants existing diagnosis uveitis, other co-morbidities or those unable complete examinations provide informed assent excluded. SLE (control) (intervention) frequency consistent national programme childhood surveillance. intervention arm also have 6 months after study entrance. Outcomes interest (recruitment attrition rates), metrics (proportion disorders entrance), quality life outcomes (PedsQL), resource use. Additionally, comparative analysis versus (‘gold standard’ reference testing) findings proof-of-concept data necessary develop undertake larger scale trial. Trial registration: registered clinicaltrails.gov ( NCT05984758 ). Summary Anterior rare form disease that commonly associated (JIA). Childhood potentially so must travel centre every two three pick up signs uveitis. compare Slit Lamp Examination (SLE) imaging-based using Coherence Tomography Segment support design study. ages twelve who past invited take part. into one arms (SLE AS-OCT) screening appointments over either modalities.

Language: Английский

Automated quantification of anterior chamber cells using swept-source anterior segment optical coherence tomography DOI Creative Commons
Shani Pillar,

Shin Kadomoto,

Keren Chen

et al.

Journal of Ophthalmic Inflammation and Infection, Journal Year: 2025, Volume and Issue: 15(1)

Published: Jan. 9, 2025

Language: Английский

Citations

0
UVESCREEN1: A randomised feasibility study of imaging-based uveitis screening for children with juvenile idiopathic arthritis- Study Protocol DOI Creative Commons
Sonali Dave, Jugnoo S. Rahi, Harry Petrushkin

et al.

PLoS ONE, Journal Year: 2025, Volume and Issue: 20(2), P. e0316410 - e0316410

Published: Feb. 12, 2025

Children with Juvenile Idiopathic Arthritis (JIA) are at a currently unpredictable risk of blinding, often asymptomatic, co-existent eye disorder, anterior uveitis which requires prompt treatment. The unpredictability this insidious disorder commits children JIA to three-monthly expert clinical examinations in specialist centres located far from their homes. Optical coherence tomography the ocular segment (AS-OCT) has been shown be an acceptable, repeatable and sensitive modality for detection, but is not standard care. This feasibility randomised controlled trial (RCT) aims inform future full-scale RCT comparing current routine practice (expert slit lamp examination, SLE) AS-OCT surveillance risk. Eighty aged between 2 12 years old diagnosed within preceding year will included. Participants existing diagnosis uveitis, other co-morbidities or those unable complete provide informed assent excluded. SLE (control) (intervention) examination frequency consistent national programme childhood surveillance. intervention arm also have 6 months after study entrance. Outcomes interest (recruitment attrition rates), metrics (proportion disorders entrance), quality life outcomes (PedsQL), resource use. Additionally, comparative analysis versus (‘gold standard’ reference testing) findings proof-of-concept data necessary develop undertake larger scale trial. Trial registration: registered clinicaltrails.gov ( NCT05984758 ).

Language: Английский

Citations

0
Differentiation of anterior chamber pigment and inflammatory cells using swept-source optical coherence tomography: a cross-sectional study DOI Creative Commons
Alice Bellchambers,

Rongling Shu,

Colin J. Chu

et al.

Eye, Journal Year: 2025, Volume and Issue: unknown

Published: March 12, 2025

Abstract Background/Objectives We aimed to investigate the potential of anterior segment OCT (AS-OCT) in differentiating chamber (AC) pigment and inflammatory cells. Subject/Methods Cross-sectional study adults with uveitis. The exclusion criterion was corneal opacity sufficient obscure slit lamp examination chamber. Reference testing comprised lamp-based detection Standardization Uveitis Nomenclature (SUN) grading intraocular inflammation. Index CASIA2 swept-source AS-OCT acquisition, semi-automated analysis detect measure hyper-reflective particles within AC. Correlations between AS-OCT-derived counts different-sized clinical grades were explored using multilevel multivariable regression analyses. Results 62 eyes (31 patients) included. There a positive correlation particle >4 pixels (equivalent >24microns), SUN (adjusted coefficient, adjCoef 24.3, 95% confidence interval 6.3 42.3, p = 0.03), strengthened clinically absent (adjCoef 20.6, 14.8 26.4, < 0.001). A also noted ≤2 presence AC clinically. Conclusions Swept-source (SS) holds utility cells AC, leading improved management individuals or at risk SS biomarkers may provide information on uveitis aetiology, supporting diagnosis underlying conditions. Further work larger cohort, replication by other investigators teams, sampling will enable future validation.

Language: Английский

Citations

0
The management of adult and paediatric uveitis for rheumatologists DOI
Sarah L. N. Clarke, Panagiotis Maghsoudlou,

Catherine Guly

et al.

Nature Reviews Rheumatology, Journal Year: 2024, Volume and Issue: 20(12), P. 795 - 808

Published: Nov. 6, 2024

Language: Английский

Citations

2
Imaging-Based Detection of Anterior Chamber Inflammation: A Comparative Diagnostic Accuracy Study DOI Creative Commons

Prithi Uthayananthan,

Nakita Tanwar,

Jugnoo S. Rahi

et al.

American Journal of Ophthalmology, Journal Year: 2024, Volume and Issue: 270, P. 131 - 139

Published: July 31, 2024

PurposeWe investigated the impact of operator parameters on diagnostic performance danterior segment optical coherence tomography (AS-OCT) in anterior uveitis.DesignProspective comparative analysis.MethodsSetting: Single site.Study Population: Children aged under 18 years with uveitis, recruited consecutively.Observation Procedures: Index testing: Optovue RTVue80 AS-OCT using 'low-volume' (LV, horizontal and vertical cross-sections) 'high-volume' (HV, 68 protocols. Reference slit lamp examination chamber inflammation graded standardisation uveitis nomenclature (SUN).Main Outcome Measure: test metrics (sensitivity, specificity, likelihood ratios), utility for 'ruling-in' 'ruling-out' disease (positive / negative predictive values, PPV/NPV), receiver operating characteristic (ROC) curves to explore different imaging derived metrics, multivariable multilevel regression analyses quantify correlation index reference testing, repeatability indices across protocols.Results40 children (77 eyes: 51 eyes at SUN grade 0, 10 SUN0.5+, 8 SUN1+, SUN≥2+ or higher) were included. There was high protocols (0.98, p<0.001, 95% CI 0.75-1.0). OCT resulted strong values (LV-scan NPV 82.9%, 71.5 - 90.4%; HV-scan 100%, 3% 100%), but less value SUN≥0.5+ PPV 52.8% 41.5 63.7%; 34.2%, 33.3 35.1%). Detection more than 1 cell within a cross sectional scan strongly suggestive clinical activity, area curve 0.76 (95% 0.62 0.89) SUN≥0.5+, 0.85 0.73- 0.98), detection SUN≥1+. Cell count correlated grades higher levels (SUN≥2+ both protocols, SUN≥1+ HV-scans). an independent positive association between age (adjusted coefficient 0.2 cells each additional year age).ConclusionsOperator dependent factors quantification inflammation. However, strong, 'dose-respondent' low-volume grading promises without storage analysis burden high-volume approaches. Further work will involve exploration need age-specific image metric interpretation.

Language: Английский

Citations

0
UVESCREEN1: A randomised feasibility study of imaging-based uveitis screening for children with juvenile idiopathic arthritis- Study Protocol DOI Creative Commons
Sonali Dave, Jugnoo S. Rahi, Harry Petrushkin

et al.

medRxiv (Cold Spring Harbor Laboratory), Journal Year: 2024, Volume and Issue: unknown

Published: Dec. 13, 2024

Abstract Children with Juvenile Idiopathic Arthritis (JIA) are at a currently unpredictable risk of blinding, often asymptomatic, co-existent eye disorder, anterior uveitis which requires prompt treatment. The unpredictability this insidious disorder commits children JIA to three-monthly expert clinical examination in specialist centres located far from their homes. Optical coherence tomography the ocular segment (AS-OCT) has been shown be an acceptable, repeatable and sensitive modality for detection, but is not standard care. This feasibility randomised controlled trial (RCT) aims inform future full-scale RCT comparing current routine practice (expert slit lamp examination, SLE) AS-OCT surveillance risk. Eighty aged between 2 12 years old diagnosed within preceding year will included. Participants existing diagnosis uveitis, other co-morbidities or those unable complete examinations provide informed assent excluded. SLE (control) (intervention) frequency consistent national programme childhood surveillance. intervention arm also have 6 months after study entrance. Outcomes interest (recruitment attrition rates), metrics (proportion disorders entrance), quality life outcomes (PedsQL), resource use. Additionally, comparative analysis versus (‘gold standard’ reference testing) findings proof-of-concept data necessary develop undertake larger scale trial. Trial registration: registered clinicaltrails.gov ( NCT05984758 ). Summary Anterior rare form disease that commonly associated (JIA). Childhood potentially so must travel centre every two three pick up signs uveitis. compare Slit Lamp Examination (SLE) imaging-based using Coherence Tomography Segment support design study. ages twelve who past invited take part. into one arms (SLE AS-OCT) screening appointments over either modalities.

Language: Английский

Citations

0