A Survey of Diagnostic and Management Practices in Retinal Vasculitis: International Uveitis Study Group (IUSG) Retinal Vasculitis Study (ReViSe)-Report 5

Abstract

Purpose: Retinal vasculitis (RV) is a complex inflammatory disorder of retinal blood vessels with variability in diagnosis, classification, and management. Despite efforts to standardize definitions, discrepancies persist regarding clinical features, systemic associations, and treatment approaches. This study aimed to assess clinical practices among uveitis specialists to identify areas requiring consensus.

Methods: A cross-sectional, semi-structured survey was conducted among members of the International Uveitis Study Group (IUSG). Eligible participants were uveitis specialists with formal training in ocular inflammation. The survey included 120 questions on diagnosis, imaging, systemic associations, and management strategies. Responses were collected anonymously via REDCap (January to August 2024).

Results: Fifty-five specialists participated, mainly from Europe, Asia, and North America. Most rated their RV knowledge as "adequate" or "proficient." While 85.5% agreed on a definition involving retinal vascular abnormalities with intraocular inflammation, variability persisted in diagnostic and management practices. Diagnostic testing prioritized infectious and systemic causes. Wide-field imaging and fluorescein angiography were commonly used. Methotrexate, mycophenolate, and adalimumab were preferred treatments. Treatment success was primarily defined by improvements in vascular leakage and macular edema. Monitoring practices and referral patterns varied.

Conclusion: Substantial variability exists in RV diagnosis and management, highlighting the need for standardized clinical guidelines.

Keywords: Diagnostic criteria; imaging modalities; retinal vasculitis; treatment; uveitis.