The role of a multicentre data repository in ocular inflammation: The Ocular Autoimmune Systemic Inflammatory Infectious Study (OASIS)

Abstract

In the current literature, clinical registry cohorts related to ocular inflammation are few and far between, and there are none involving multi-continental international data. Many existing registries comprise administrative databases, data related to specific uveitic diseases, or are designed to address a particular clinical problem. The existing data, although useful and serving their intended purposes, are segmented and may not be sufficiently robust to design prognostication tools or draw epidemiological conclusions in the field of uveitis and ocular inflammation. To solve this, we have developed the Ocular Autoimmune Systemic Inflammatory Infectious Study (OASIS) Clinical Registry. OASIS collects prospective and retrospective data on patients with all types of ocular inflammatory conditions from centers all around the world. It is a primarily web-based platform with alternative offline modes of access. A comprehensive set of clinical data ranging from demographics, past medical history, clinical presentation, working diagnosis to visual outcomes are collected over a range of time points. Additionally, clinical images such as optical coherence tomography, fundus fluorescein angiography and indocyanine green angiography studies may be uploaded. Through the capturing of diverse, well-structured, and clinically meaningful data in a simplified and consistent fashion, OASIS will deliver a comprehensive and well organized data set ripe for data analysis. The applications of the registry are numerous, and include performing epidemiological analysis, monitoring drug side effects, and studying treatment safety efficacy. Furthermore, the data compiled in OASIS will be used to develop new classification and diagnostic systems, as well as treatment and prognostication guidelines for uveitis.

Fig. 1. A screenshot displaying the data points collected on the Working Diagnosis page of the OASIS Clinical Registry.

a Diagnoses are grouped into infective, non-infective, masquerade and others. b The list of infective aetiologies that appear once “Infective” is selected as the etiological diagnosis. c The list of non-infective aetiologies that appear once “Non-infective” is selected as the etiological diagnosis. d The list of masquerade diagnoses that appear once “Masquerade” is selected as the etiological diagnosis.

Fig. 2. A screenshot displaying the data points collected on the “Visit Summary” page of the OASIS platform.

These include data on disease progression, as well as the main cause of vision loss and visual potential of each eye. OD oculus dexter, OS oculus sinister.

Fig. 3. A screenshot displaying the data points collected on the “Course of disease” page of the OASIS platform.

Users may indicate if the disease is acute in nature, chronic or recurrent, and if any immunosuppresants were administered.

Fig. 4. A screenshot of the Overview Tab (boxed in red) shown at the top of each patient record.

This easily accessible summary of patient details provides users with a useful overview of the patient’s profile.

Fig. 5. A diagrammatic representation of the process of data and image processing using artificial intelligence (AI) in the OASIS registry.

Data collected from the registry will be utilised to train AI models that may ultimately assist clinicians in diagnosis, prognostication or treatment.

Fig. 6. The proposed OASIS classification complementing the existing SUN Working Group criteria.

In the proposed classification, retinal vasculitis is classified as a separate entity from posterior uveitis, and extraocular inflammatory entities are included.

Fig. 7. A diagrammatic representation of a step-ladder approach to diagnosis of uveitic conditions.

By utilising this step-ladder approach, the number of investigations performed by clinicians to reach a diagnosis can be reduced, leading to better cost-efficiency.