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K. Konstantopoulou, R. Dell' Omo, A. M. S. Morley, D. Karagiannis, C. Pavesio; A Comparison of Qualitative and Quantitative Measures of Anterior Segment Flare in Patients With Uveitis. Invest. Ophthalmol. Vis. Sci. 2008;49(13):5826. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
to identify discrepancies between the standard qualitative assessment of anterior uveitis according to the Standarization of Uveitis Nomenclature classification and the laser flare meter KOWA FC 1000.Methods: In total 101eyes were tested from 73 uveitic patients.Three clinicians independently graded anterior chamber flare according to the SUN classification and immediately after, the same patients had flare reading measured by an experienced technician using the laser flare meter KOWA FC 1000.
52 (71 %) of the patients were female. The median (interquartile range) age of the patients was 42 (31-54) years. 29 of the subjects were white Caucasian, 19 described themselves as being of african origin and 22 patients were Asian.Only one eye was identified with +3 flare and that was graded by the laser flare meter as 648, 8 photons/ms. Twenty seven eyes were graded as presenting anterior chamber flare +2, by the most experienced ophthalmologist. In 17 out them all clinicians were in agreement, the rest differed by order of 1 grade, according to the SUN classification and the reading range of the laser flare meter for these 27 eyes was 5,2 - 899,1 photons/ms. Median value was 41, 4.Sixty two eyes were graded as presenting with flare +1 by the most experienced clinician. Agreement between the examiners was established in 34 of them. Disagreement was again by the order of 1 and the flare meter range for the most senior examiner was 2 - 137, 6 photons/ms and median value was 18, 5. For clinical measure of flare 0 and +0,5, clinicians disagreed in 10 out of the 11 eyes again by the order of 1. The flare meter readings ranged from 1,1 - 169,9 photons/ms and median value was 11,8.
The wide range of values observed with the laser flare meter for each of the clinical grades indicates that the subjectivity of the clinical assessment makes it a less useful tool for clinical studies. This is further complicated by the variability of readings between observers. It is also, a poor method for identifying more severe cases of blood-aqueous barrier breakdown, which is relevant to the decision process of initiating treatment and accurately assessing therapy response.
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