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A comparative study between clinical grading of anterior chamber flare and flare reading using the Kowa laser flare meter

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Abstract

To assess the accuracy of standard clinical grading of aqueous flare in uveitis according to the Standardization of Uveitis Nomenclature consensus, and compare the results with the readings of the laser flare meter, Kowa 500. Two examiners clinically graded the flare in 110 eyes. The flare was then measured using the Kowa laser flare meter. Twenty-nine eyes were graded as anterior chamber flare +2; for 18 of these, the clinicians were in agreement, the rest differed by the order of one grade. The range of the laser flare meter for these eyes was 5.2–899.1 photons/ms. The median value was 41.4. Seventy-four eyes were graded with flare +1. Agreement was established in 51 of these eyes. Disagreement for the rest was again by the order of 1, and the flare meter range was 1.1–169.9 photons/ms, median value 18.4. For the clinical measure of flare 0, the clinicians disagreed on three out of five eyes. The flare meter readings ranged from 2.5 to 14.1 photons/ms, median value 9.9. Only two eyes were graded with flare +3 and there was one step disagreement on both of them. We found little evidence of association between the flare readings and intraocular pressure or age. Our findings suggest that clinical evaluation of aqueous flare is subjective. Compared with the Kowa laser flare meter’s numeric readings, the discrepancies observed indicate that clinical grading is an approximate science. The laser flare meter provides an accurate, reproducible, non-invasive assessment of aqueous flare that can prove valuable in research and clinical decisions.

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Acknowledgments

This research has received a proportion of its funding from the Department of Health’s NIHR Biomedical Research Centre for Ophthalmology at Moorfields Eye Hospital and UCL Institute of Ophthalmology. The views expressed in the publication are those of the authors and not necessarily those of the Department of Health. The study has been approved by the appropriate ethics committee and all persons gave their informed consent prior to their inclusion in the study. It has therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

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Authors and Affiliations

  1. Medical Retina Department, Moorfields Eye Hospital, 162 City Road, London, EC1V 2PD, UK

    Kallirroi Konstantopoulou, Roberto Del’Omo, Anne M. Morley, Dimitris Karagiannis & Carlos Pavesio

  2. Research Department, Moorfields Eye Hospital, 162 City Road, London, EC1V 2PD, UK

    Catey Bunce

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  1. Kallirroi Konstantopoulou
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  2. Roberto Del’Omo
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  3. Anne M. Morley
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  4. Dimitris Karagiannis
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  5. Catey Bunce
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  6. Carlos Pavesio
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Correspondence to Kallirroi Konstantopoulou.

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Konstantopoulou, K., Del’Omo, R., Morley, A.M. et al. A comparative study between clinical grading of anterior chamber flare and flare reading using the Kowa laser flare meter. Int Ophthalmol 35, 629–633 (2015). https://doi.org/10.1007/s10792-012-9616-3

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  • DOI: https://doi.org/10.1007/s10792-012-9616-3

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