Iris Vascular Characteristics Changes in Non-Infectious Uveitis: A Wide-Field Swept-Source Anterior Segment Optical...

To quantitatively assess differences in iris vascular characteristics among patients with active non-infectious uveitis (NIU), inactive NIU, and healthy controls using wide-field swept-source anterior segment optical coherence tomography angiography (SS-AS-OCTA), and to identify reliable imaging biomarkers for monitoring NIU.

This cross-sectional observational study involved 87 eyes from 48 participants, categorized into active NIU (29 eyes), inactive NIU (28 eyes), and healthy controls (30 eyes) groups. Iris vascular characteristics were analyzed using wide-field SS-AS-OCTA. Iris vessel area density (VAD) and vessel length density (VLD) were measured in six regions of the iris: the inner one-third, outer two-thirds, and full range of both the nasal and temporal sides.

Active NIU eyes showed significantly higher VAD than inactive eyes across five regions (all p < 0.001), except the nasal outer two-thirds (p = 0.002). Compared to healthy controls, the active group exhibited significantly higher VAD and VLD across all six regions (both p < 0.001). Similarly, VLD was significantly higher in active NIU than in both inactive and healthy eyes (all p < 0.001). In active NIU eyes, temporal full range VAD correlated positively with anterior chamber (AC) cell grade (ρ = 0.619, p < 0.001).

Wide-field SS-AS-OCTA effectively detects iris vascular changes in active NIU. While both VAD and VLD are valuable indicators of disease activity, VAD in the temporal region was significantly correlated with clinical inflammatory severity, offering a more informative imaging biomarker. These objective, non-invasive metrics support longitudinal monitoring and treatment assessment.