Aqueous Humor, Infection, Uveitis
Conditions
Keywords
Metagenomics, Uveitis, Aqueous Humor, Ophthalmology
Brief summary
The aim of this study is to apply a diagnostic test called 'metagenomic sequencing' to identify the involvement of potential infections in patients with ocular inflammation, where this hasn't been detected by currently available standard testing. For many people with ocular inflammation, no cause is ever found for their disease. In some cases, an infection or infectious trigger is suspected, but currently available tests are inadequate. Metagenomic sequencing can identify almost every globally known infection (bacteria, virus, fungi, parasites) in a sample. Therefore, it has the potential to identify an infection that has caused or triggered ocular inflammation, and as a consequence may help to identify specific treatments. It has the potential to improve our understanding of how to diagnose and treat people with this problem. This study will allow us to test the technique that has been previously optimised for brain infections, on ocular fluids. Participants will be 18 years of age or over and have active ocular inflammation which is suspected to be due to an infection, or an autoimmune process which has been triggered by an infection, but identification of this infection has not been possible using the investigations available as part of standard NHS care. Participants will be identified by the treating clinical team as requiring a sample of fluid from inside of the eye, and some of this fluid will be sent for metagenomic sequencing alongside standard testing. This study will be conducted at Moorfields Eye Hospital, London and will last for approximately a year. Participants will undergo additional non-invasive ocular imaging on the day of their clinic visit, but will not have to attend any additional research visits.
Interventions
DIAGNOSTIC_TESTMetagenomic sequencing of aqueous humor
Metagenomic Sequencing on aqueous humor surplus to diagnostic requirements
DIAGNOSTIC_TESTOcular Imaging
Ocular imaging with anterior segment OCT, laser flare photometry, confocal microscopy and colour fundus photography.
Sponsors
Moorfields Eye Hospital NHS Foundation Trust
Great Ormond Street Hospital for Children NHS Foundation Trust
Study design
Observational model
CASE_ONLY
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Healthy volunteers
No
Inclusion criteria
1. 18 years of age or older with the capacity to consent 2. Standard of care has not determined a clinical diagnosis 3. Active ocular inflammation with risk of visual loss 4. Clinically suspected infectious or para-infectious cause of ocular inflammation
Exclusion criteria
1. Contraindication to ocular fluid sampling 2. Where an urgent result within 5 days is clinically required
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| The percentage of participants who receive a clinically viable result from metagenomic sequencing | 12 months |
Secondary
| Measure | Time frame |
|---|---|
| The number of patients who receive a result that leads to a change in treatment and beneficial outcome from metagenomic sequencing | 12 months |
Countries
United Kingdom
Contacts
CONTACTResearch Administration at Moorfields Eye Hospital R&D
Outcome results
None listed