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Published on: January 21, 2018
Imaging Measures for the Assessment of Disease Activity in Noninfectious Posterior Uveitis - Multimodal Imaging in
Aniruddha Agarwal1, Prithvi Ramtohul2, Alessandro Invernizzi3
1From the Department of Ophthalmology (A.A.), Integrated Surgical Institute (ISI), Cleveland Clinic Abu Dhabi, Abu Dhabi, UAE; Cleveland Clinic Lerner College of Medicine (A.A.), Cleveland, Ohio, USA.
Purpose:
To develop imaging-based measures for disease assessment in noninfectious posterior uveitis (NIPU).
Design:
A mixed-methods design, beginning with a review of previously developed imaging recommendations formulated by separate subcommittees of the multimodal imaging in uveitis (MUV) initiative, followed by a structured consensus process using the nominal group technique (NGT), facilitated by an independent expert committee.
Methods:
An expert committee reviewed and extracted all consensus-based imaging recommendations from the MUV subcommittee manuscripts focused on five major NIPU entities. The primary objective was to categorize imaging features as suggestive of active disease (SAD), suggestive of inactive disease (SID), or equivocal. This process was conducted using the NGT to reach consensus-based imaging measures. These recommendations were further voted upon by members of the full task force.
Results:
A total of 49 imaging statements were deliberated using two rounds of NGT and independent voting. For the five included diseases, a total of 21 statements qualified as features of SAD, whereas 12 statements were classified as SID. The remaining 16 statements were categorized as equivocal features that need further investigation to determine whether the disease is active.
Conclusions:
This study builds upon the multinational efforts of the MUV initiative to extend the standardization of uveitis nomenclature (SUN) work through the integration of additional multimodal imaging information. Defining clear imaging-based outcome measures for NIPU, it establishes a structured framework supporting objective disease assessment. These standardized imaging measures are expected to enhance the utility of multimodal imaging in both routine uveitis care and future clinical trials.
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