Abstract
In case of intraocular inflammation, blood-ocular barriers are disrupted allowing serum proteins as well as cells to enter the eye. The normal noninflamed status and the different levels of intraocular inflammation can be observed in the aqueous humor that is visually accessible through the cornea. The two inflammatory parameters obtained by slit-lamp examination are aqueous cells seen as particles identified by backscattering light from the incoming beam and the “Tyndall effect” or flare, an optical phenomenon caused by the backscattering of light by “cloudy matters” of small molecular size, here aqueous proteins, producing a milky beam, described for the first time by Lord John Tyndall in 1869. Efforts were made to establish standardized ways to evaluate the level of inflammation in the anterior chamber, and a grading system was put forward by Hogan, Kimura, and Thygeson at the Proctor Foundation in San Francisco. They established scores from 0 to 4 for both flare and cells that are shown for flare on Table 15.1. This system was used for the last half century because there was no other better alternative.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Bernasconi O, Auer C, Ladas JG et al (1998) Relation between laser flare photometry and clinical outcomes in HLA-B27 related anterior uveitis. Invest Ophthalmol Vis Sci 39(4):S359
Bernasconi O, Papadia M, Herbort CP (2010) Sensitivity of laser flare photometry compared to slit-lamp cell evaluation in monitoring anterior chamber inflammation in uveitis. Int Ophthalmol 30:495–500
Bigar F, Herbort CP, Pittet N (1991) Tyndallométrie de la chambre antérieure avec le Laser Flare-Cell Meter Kowa FC-1000. Klin Monatsbl Augenheilkd 198:396–398
Davis JL, Dacanay LM, Holland GN et al (2003) Laser flare photometry and complications of uveitis in children. Am J Ophthalmol 135:763–771
De Ancos E, Pittet N, Herbort CP (1994) Mesure quantitative de l’inflammation dans l’uvéite antérieure aiguë (UAA) HLA-B27 à l’aide du laser flare-cell meter Kowa FC-1000. Klin Monatsbl Augenheilkd 204:330–333
El-Maghraby A, Marzouki A, Matheen TM et al (1992) Reproducibility and validity of laser flare/cell meter measurement as an objective method of assessing intraocular inflammation. Arch Ophthalmol 110:960–962
El-Maghraby A, Marzouki A, Matheen TM et al (1993) Reproducibility and validity of laser flare/cell meter measurement of intraocular inflammation. J Cataract Refract Surg 19:52–55
Fang W, Zhou H, Yang P et al (2008) Longitudinal quantification of aqueous flare and cells in Vogt-Koyanagi-Harada disease. Br J Ophthalmol 92:182–185
Gonzales CA, Ladas JG, Davis JL et al (2001) Relationships between laser flare photometry values and complications of uveitis. Arch Ophthalmol 119:1763–1769
Guex-Crosier Y, Pittet N, Herbort CP (1994) Evaluation of laser flare-cell photometry in the appraisal and management of intraocular inflammation in uveitis. Ophthalmology 101:728–735
Guex-Crosier Y, Pittet N, Herbort CP (1995) Sensitivity of laser flare photometry to monitor inflammation in uveitis of the posterior segment. Ophthalmology 102:613–621
Herbort CP, Guex-Crosier Y, De Ancos E et al (1997) Use of laser flare photometry to assess and monitor inflammation in uveitis. Ophthalmology 104:64–72
Herbort CP, Tugal-Tutkun I (2010) Editorial: laser flare (cell) photometry: 20 years already. Int Ophthalmol 30:445–447
Hogan MJ, Kimura SJ, Thygeson P (1959) Signs and symptoms of uveitis. I. Anterior uveitis. Am J Ophthalmol 47:155–170
Ikeji F, Pavesio C, Bunce C, White E (2010) Quantitative assessment of the effects of papillary dilation on aqueous flare in eyes with chronic anterior uveitis using laser flare photometry. Int Ophthalmol 30:491–494
Jabs DA, Nussenblatt RB, Rosenbaum JT, Standardization of Uveitis Nomenclature (SUN) Working Group (2005) Standardization of uveitis nomenclature for reporting clinical data. Results of the First International Workshop. Am J Ophthalmol 140:509–516
Kempen JH, Ganesh SK, Sangwan VS, Rathinam SR (2008) Interobserver agreement in grading activity and site of inflammation in eyes of patients with uveitis. Am J Ophthalmol 146:813–818
Konstantopoulou K, Del’omo R, Morley AM et al (2012) A comparative study between clinical grading of anterior chamber flare and flare reading using the Kowa laser flare meter. Int Ophthalmol [Epub ahead of print]
Küchle M, Nguyen NX, Schalnus R et al (1994) Tyndallometrie mit dem Laser-flare-cell-photometer und biochemische Proteinbestimmung im Kammerwaser bei Augen mit Pseudoexfoliations syndrom. Ophthalmologe 91:578–584
Ladas JG, Wheeler NC, Morhun PJ et al (2005) Laser flare-cell photometry: methodology and clinical applications. Surv Ophthalmol 50:27–47
Ni M, Bloom JN, Lele S et al (1992) A laboratory evaluation of the Kowa laser flare cell meter for the study of uveitis. Graefes Arch Clin Exp Ophthalmol 230:547–551
Onodera T, Gimbel HV, DeBroff BM (1993) Aqueous flare and cell number in healthy caucasians. Jpn J Ophthalmol 37:445–451
Oshika T, Araie M, Masuda K (1988) Diurnal variation of aqueous flare in normal human eyes measured with the laser flare-cell meter. Jpn J Ophthalmol 32:143–150
Oshika T, Sakurai M, Araie M (1993) A study on diurnal fluctuation of blood-aqueous barrier permeability to plasma proteins. Exp Eye Res 56:129–133
Rodinger ML, Hessemer V, Schmitt K et al (1993) Reproducibility of in vivo determination of protein and particle concentration with the laser flare-cell photometer. Ophthalmologe 90:742–745
Sawa M, Tsurimaki Y, Tsuru T et al (1988) New quantitative method to determine protein concentration and cell number in aqueous in vivo. Jpn J Ophthalmol 32:132–142
Shah SM, Spalton DJ, Smith SE (1991) Measurement of aqueous cells and flare in normal eyes. Br J Ophthalmol 75:348–352
Shah SM, Spalton DJ, Taylor JC (1992) Correlation between laser flare measurement and anterior chamber protein concentration. Invest Ophthalmol Vis Sci 33:2878–2884
Spalton DJ (1993) Measurement of flare. Br J Ophthalmol 77:263–264
Tappeiner C, Heinz C, Roesel M, Heiligenhaus A (2011) Elevated laser flare values correlate with complicated course of anterior uveitis in patients with juvenile idiopathic arthritis. Acta Ophthalmol 89:e521–e527
Tugal-Tutkun I, Cingu K, Kir N et al (2008) Use of laser flare-cell photometry to quantify intraocular inflammation in patients with Behçet uveitis. Graefes Arch Clin Exp Ophthalmol 246:1169–1177
Tugal-Tutkun I, Herbort CP (2010) Laser flare photometry: a noninvasive, objective, and quantitative method to measure intraocular inflammation. Int Ophthalmol 30:453–464
Tugal-Tutkun I, Yalçindağ FN, Herbort CP (2012) Laser flare photometry and its use in uveitis. Expert Rev Ophthalmol 7:449–457
Tyndall J (1869) On the blue of the sky, the polarization of the skylight, and on the polarization of light by cloudy matter generally. Philos Mag J Sci 37:384–404
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2016 Springer-Verlag Berlin Heidelberg
About this chapter
Cite this chapter
Herbort, C.P., Tugal-Tutkun, I. (2016). Laser Flare Photometry. In: Zierhut, M., Pavesio, C., Ohno, S., Orefice, F., Rao, N. (eds) Intraocular Inflammation. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-75387-2_15
Download citation
DOI: https://doi.org/10.1007/978-3-540-75387-2_15
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-540-75385-8
Online ISBN: 978-3-540-75387-2
eBook Packages: MedicineMedicine (R0)