title: The effectiveness of pharmacological agents for the treatment of uveitic macular oedema (UMO): a systematic review protocol.
abstract: BACKGROUND
  Macular oedema (MO) describes the accumulation of fluid in the central part of the retina, known as the 'macula' which provides central vision. MO is the leading cause of sight loss in patients with intraocular inflammation (uveitis). There is a lack of consensus over the treatment of uveitic macular oedema (UMO). The proposed systematic review will evaluate the evidence on the effectiveness of pharmacological agents used to treat UMO. All systemic, local, or topical pharmacological agents will be included.
  
  
  METHODS
  Standard systematic review methodology will be employed to identify, select and extract data from comparative studies (randomised/non-randomised trials and observational studies) of the pharmacological interventions in patients with UMO. Searches will be conducted through bibliographic databases (Cochrane Library, MEDLINE, EMBASE and CINAHL) and clinical trials registers. No restriction will be placed on either language or year of publication. Translation of non-English language articles will be undertaken to minimise selection bias. The primary outcome of interest will be best corrected visual acuity and secondary outcomes will be adverse events, health-related quality of life, assessment of UMO using central macular thickness (e.g. by optical coherence topography (OCT)), clinical and angiographic assessment of UMO, clinical estimation of vitreous haze. Risk of bias assessment appropriate to each study design will be undertaken. Data will be grouped by comparison, tabulated and narratively synthesised. Meta-analysis will be undertaken where clinical and methodological homogeneity exists. Subgroup and sensitivity analyses, also network analyses and intra/inter-pharmacological class analyses will be undertaken where deemed appropriate.
  
  
  CONCLUSIONS
  A number of published studies have investigated the effectiveness of the pharmacological agents used to treat UMO. However, there is no recent systematic review that synthesises this evidence. This systematic review will analyse the effectiveness of systemic, local and topical therapies to treat UMO. The findings will provide important evidence to inform clinical and health policy decision-making for the treatment of UMO.
  
  
  BACKGROUND
  Prospero CRD42015019170.
authors.affiliation: Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK. mxt500@bham.ac.uk.
authors.forename: Mohammad O
authors.initials: MO
authors.lastname: Tallouzi
authors.affiliation: Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK. d.j.moore@bham.ac.uk.
authors.forename: David J
authors.initials: DJ
authors.lastname: Moore
authors.affiliation: Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK. m.calvert@bham.ac.uk.
authors.forename: Melanie
authors.initials: M
authors.lastname: Calvert
authors.affiliation: Institute of Immunology and Immunotherapy, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK. p.i.murray@bham.ac.uk.
authors.forename: Philip I
authors.initials: PI
authors.lastname: Murray
authors.affiliation: Birdshot Uveitis Society representative, Birmingham, UK. nickbucknell@hotmail.co.uk.
authors.forename: Nicholas
authors.initials: N
authors.lastname: Bucknall
authors.affiliation: Department of Ophthalmology, Queen Elizabeth hospital, University Hospitals Birmingham NHS Foundation Trust, Edgbaston, Birmingham, B15 2WB, UK. a.denniston@bham.ac.uk.
authors.forename: Alastair K
authors.initials: AK
authors.lastname: Denniston
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D002257:Carbonic Anhydrase Inhibitors / Q000627:therapeutic use*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008269:Macular Edema / Q000188:drug therapy* / Q000209:etiology; D000078202:Systematic Reviews as Topic; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors; D014605:Uveitis / Q000150:complications / Q000188:drug therapy*; D015201:Meta-Analysis as Topic
chemical_list: D000305:Adrenal Cortex Hormones; D020533:Angiogenesis Inhibitors; D002257:Carbonic Anhydrase Inhibitors; D007166:Immunosuppressive Agents; D014409:Tumor Necrosis Factor-alpha