Imaging in uveitis: techniques and indications

Purpose To present the array of the main imaging methods used or that should be used in the investigation of uveitis and specify their respective indications. Methods Review of the different imaging modalities as well as laser flare photometry (LFP). Results Imaging work‐up of (posterior) uveitis automatically and routinely always comprised FA and more recently OCT. FA usually does not bring new unknown elements as it gives information on the superficial structures accessible to fundus examination but it allows more precise appraisal of the pathology of these superficial structures such as retinal vasculitis, macular oedema, retinal ischemia, subretinal fluid, retinal neovessels as well as optic disc inflammation. OCT gives morphologic quasi‐histologic details of the retina, especially useful because it is non‐invasive and allows close follow‐up. FAF gives information on inflammation induced changes on the retinal pigment epithelium and photoreceptor outer segments but FAF still needs to be better standardized if possible at all. Mostly, these methods fail to give information on the choroid, at least as often involved as the retina, which can only be explored by ICGA. Unlike FA and OCT, ICGA very often shows occult unknown elements. It is therefore obvious that ICGA should be included in routine imaging work‐up of those cases of posterior uveitis where angiography is deemed necessary and choroiditis cannot be excluded. Conclusion Classical imaging methods and newer modalities together with LFP transformed uveitis monitoring into a precise clinical science, as long as these methods are used which unfortunately is far from being the case.