Sensitivity of laser flare photometry compared to slit-lamp cell evaluation in monitoring anterior chamber inflammation in uveitis

Abstract

To study the sensitivity of laser flare photometry (LFP) in monitoring anterior chamber inflammation by correlating LFP measurements with slit-lamp evaluation of aqueous cells in HLA-B27-related uveitis in a prospective trial. Slit-lamp cell evaluation was correlated with LFP-measured flare in a masked fashion in HLA-B27-related uveitis patients receiving standard topical therapy. At the time of 50 and 90% LFP flare reduction, the corresponding reduction of cells was recorded and statistically compared using the sign test. Forty-three episodes (in 43 patients) of acute anterior HLA-B27-related uveitis were included. LFP flare reduction and slit-lamp cell reduction were strongly correlated. LFP was significantly more sensitive for both 50% (P = 0.001) and 90% (P = 0.02) LFP flare reduction in assessing the decrease of anterior chamber inflammation. LFP was superior to slit-lamp cell evaluation in monitoring anterior chamber inflammation in uveitis. Flare, becoming a quantitative parameter when measured by LFP, rather than cells, should be considered the gold standard to measure anterior chamber inflammation in uveitis.

Correlation between anterior chamber characteristics and laser flare photometry immediately after femtosecond laser treatment before phacoemulsification

“…Oshika et al 16 have found an increase in flare photometry with age and corresponding higher preoperative flare value in older patients. 14 In our study, no significant correlation of the factor age could be shown.…”

“…10,14 Damage to the blood-aqueous barrier immediately after cataract surgery was related to the type of surgery, systemic diseases, incision size, bubble formation, and the mechanical trauma to the uveal tissues. 2,[15][16][17][18] Abell et al 19 demonstrated that lower anterior segment inflammation was observed in FLACS versus manual surgery.…”

The importance of quantitative measurement methods for uveitis: laser flare photometry endorsed in Europe while neglected in Japan where the technology measuring quantitatively intraocular inflammation was developed

“…Even in the absence of cells, LFP could detect active and treatable inflammation as was shown in a group of patients with JIA-associated uveitis without aqueous cells, where a significant flare reduction after introduction of maximal therapy was obtained [7]. It was further shown that LFP-flare was superior to slit-lamp cell evaluation for the follow-up of inflammation in acute inflammation measured in HLA-B27-related uveitis [8].…”

Editorial: Laser flare (cell) photometry: 20 years already

“…Even in the absence of cells, LFP can detect active and treatable inflammation, as was shown in a group of patients with juvenile idiopathic arthritis-associated uveitis, where a significant flare reduction after introduction of maximal therapy was demonstrated [6]. In this issue a clinical research article shows that LFP-measured flare is superior to slit-lamp cell count for the followup of inflammation in acute cases of HLA-B27-related uveitis [7]. In essence, LFP is to uveitis what tonometry is to glaucoma: it allows measurement of the level of intra-ocular inflammation at any given time point.…”