What are the key predictors of visual function recovery in uveitis? A systematic review and meta-analysis unraveling...

Uveitis represents a heterogeneous inflammatory disorder of the uveal tract that remains a major cause of preventable blindness worldwide. Visual recovery following uveitis is highly variable, influenced by complex interactions between structural, genetic, inflammatory, and therapeutic factors. Understanding these predictors is crucial for optimizing management and prognosis.

To identify and synthesize key predictors of visual function recovery in patients with uveitis-associated vision loss through a systematic review and meta-analysis.

A comprehensive search of PubMed, Cochrane Library, Scopus, Web of Science, Embase and ScienceDirect was conducted for studies published between January 2000 and August 2025. Eligible randomized controlled trials and cohort studies evaluating clinical, structural, or genetic predictors of visual recovery were included. Data were analyzed using Comprehensive Meta-Analysis software, with effect sizes expressed as standardized mean differences (SMDs) or odds ratios (ORs). Methodological quality was assessed using the Newcastle-Ottawa Scale and ROBINS-I tool.

Fourteen studies met inclusion criteria. Meta-analysis demonstrated a significant overall improvement in best-corrected visual acuity (BCVA; SMD = 0.303; p < 0.001). Retinal structural integrity showed a strong association with visual recovery (SMD = 0.652), and the odds of achieving visual acuity 20/200 or better increased significantly (OR = 2.65; p < 0.001). Genetic polymorphisms in CCR2/CCR5 were associated with visual outcomes, although genetic evidence was limited and requires independent validation; preserved retinal architecture and longer treatment duration were consistently associated with better visual recovery.

Visual function recovery in uveitis depends on structural preservation, inflammation control, and genetic determinants. Early detection and sustained treatment targeting retinal integrity are essential to prevent irreversible vision loss and enhance patient-specific prognostication.