Dietary and lifestyle interventions in non-infectious uveitis: protocol for a systematic review
File(s)
Author(s)
Type
Journal Article
Abstract
Introduction
Non-infectious uveitis (NIU) is a significant cause of visual impairment - often requiring long-term immunosuppressive therapy (which carries systemic side effects). There is growing interest in non-pharmacological adjuncts - broadly encompassing: dietary supplements, lifestyle modifications and psychological interventions – as an adjunct to treatment. However, the existing evidence is fragmented and lacks systematic synthesis.
This is the first systematic review to identify and evaluate studies examining the relationship between modifiable lifestyle behaviours or dietary supplements and clinical outcomes in NIU, across both adult and paediatric populations.
Methods
A comprehensive literature search will be conducted across Ovid Medline, Ovid Embase, CENTRAL, CINAHL, Scopus, Web of Science, and grey literature - with no date or language restrictions. Eligible studies will include randomised controlled trials (RCTs) and non-randomised controlled studies.
Primary outcomes include flare frequency/severity, visual acuity, treatment response, and adverse events. Secondary outcomes include health-related quality of life, inflammatory markers, and mental health outcomes. Two reviewers will independently screen studies, extract data, and assess risk of bias using Risk of Bias 2 (RoB 2) and Risk of Bias in Non-randomised Studies of Interventions (ROBINS-I) tools. Certainty of evidence will be evaluated using Grading of Recommendations, Assessment, Development and Evaluations (GRADE). A narrative synthesis will be conducted, with meta-analysis where appropriate, and heterogeneity assessed using I². Subgroup and sensitivity analyses will explore age, uveitis subtype, intervention type, and study quality.
Ethics and Dissemination:
No ethical approval is required as this review synthesises publicly available data. Findings will be disseminated via peer-reviewed publication, professional conferences, patient advocacy organisations (e.g., Uveitis UK). The protocol was prospectively registered with PROSPERO in August 2025 (CRD420241077488) and follows Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P) guidelines.
Non-infectious uveitis (NIU) is a significant cause of visual impairment - often requiring long-term immunosuppressive therapy (which carries systemic side effects). There is growing interest in non-pharmacological adjuncts - broadly encompassing: dietary supplements, lifestyle modifications and psychological interventions – as an adjunct to treatment. However, the existing evidence is fragmented and lacks systematic synthesis.
This is the first systematic review to identify and evaluate studies examining the relationship between modifiable lifestyle behaviours or dietary supplements and clinical outcomes in NIU, across both adult and paediatric populations.
Methods
A comprehensive literature search will be conducted across Ovid Medline, Ovid Embase, CENTRAL, CINAHL, Scopus, Web of Science, and grey literature - with no date or language restrictions. Eligible studies will include randomised controlled trials (RCTs) and non-randomised controlled studies.
Primary outcomes include flare frequency/severity, visual acuity, treatment response, and adverse events. Secondary outcomes include health-related quality of life, inflammatory markers, and mental health outcomes. Two reviewers will independently screen studies, extract data, and assess risk of bias using Risk of Bias 2 (RoB 2) and Risk of Bias in Non-randomised Studies of Interventions (ROBINS-I) tools. Certainty of evidence will be evaluated using Grading of Recommendations, Assessment, Development and Evaluations (GRADE). A narrative synthesis will be conducted, with meta-analysis where appropriate, and heterogeneity assessed using I². Subgroup and sensitivity analyses will explore age, uveitis subtype, intervention type, and study quality.
Ethics and Dissemination:
No ethical approval is required as this review synthesises publicly available data. Findings will be disseminated via peer-reviewed publication, professional conferences, patient advocacy organisations (e.g., Uveitis UK). The protocol was prospectively registered with PROSPERO in August 2025 (CRD420241077488) and follows Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P) guidelines.
Date Acceptance
2026-09-28
Citation
BMJ Open
ISSN
2044-6055
Publisher
BMJ Publishing Group
Journal / Book Title
BMJ Open
Copyright Statement
Copyright This paper is embargoed until publication. Once published the Version of Record (VoR) will be available on immediate open access.
License URL
Publication Status
Accepted