Advances in imaging retinal inflammation

Abstract

Imaging of retinal inflammation has emerged as a promising approach for the diagnosis and management of a wide range of ocular inflammatory conditions, particularly those involving uveal edema-including the iris, ciliary body, and choroid. Recent advancements in imaging technologies have markedly enhanced our ability to quantify and monitor retinal inflammation with greater precision and objectivity. Optical coherence tomography (OCT), especially spectral-domain and swept-source OCT, enables high-resolution visualization of retinal architecture and allows for the quantification of parameters such as central retinal thickness and vitreous haze. Widefield fluorescein angiography (FA) remains indispensable for assessing retinal vascular leakage, a sensitive marker of posterior segment inflammation. Furthermore, novel modalities such as OCT angiography (OCTA) offer detailed, non-invasive evaluation of the retinal microvasculature, facilitating the detection of microvascular alterations and areas of non-perfusion, as seen in diabetic retinopathy. The development of automated image analysis software has further advanced the field by providing objective and reproducible quantification of inflammatory markers, including anterior chamber cell counts and vitreous haze, thereby surpassing the limitations of traditional clinical grading systems. These imaging modalities not only improve diagnostic accuracy but also enable more effective monitoring of therapeutic response and disease progression. Multimodal imaging strategies integrate various techniques to afford a comprehensive assessment of retinal and choroidal lesions, inflammation of retinal vessels and the optic nerve, retinal ischemia, and cystoid macular edema. As these technologies continue to evolve, they hold significant promise for enhancing patient care through earlier detection of inflammation, more precise monitoring of treatment efficacy, and the facilitation of novel therapeutic development for uveitis and other retinal inflammatory disorders.

Keywords: Inflammation; Retina; Retinal vascular disease; molecular imaging.