Evidence and Consensus-Based Imaging Guidelines in Multifocal Choroiditis With Panuveitis and Punctate Inner Choroiditis—Multimodal Imaging in Uveitis (MUV) Taskforce Report 5 - 08/07/25
Doi : 10.1016/j.ajo.2025.04.018
Sapna Gangaputra 1, ⁎ 
, Aniruddha Agarwal 2, 3, Jeannette Ossewaarde-van Norel 4, Edmund Tsui 5, Jennifer E. Thorne 6, 7, Alejandra de-la-Torre 8, Michael Altaweel 9, 10, Jyotirmay Biswas 11, Srinivas Sadda 12, Alessandro Invernizzi 13, 14, Rupesh Agrawal 15, 16, 17, 18, Jessica G. Shantha 19, Massimo Accorinti 20, Amani Fawzi 21, Douglas A. Jabs 6, 22, David Sarraf 5, Vishali Gupta 23, ⁎
on behalf of the
, Aniruddha Agarwal 2, 3, Jeannette Ossewaarde-van Norel 4, Edmund Tsui 5, Jennifer E. Thorne 6, 7, Alejandra de-la-Torre 8, Michael Altaweel 9, 10, Jyotirmay Biswas 11, Srinivas Sadda 12, Alessandro Invernizzi 13, 14, Rupesh Agrawal 15, 16, 17, 18, Jessica G. Shantha 19, Massimo Accorinti 20, Amani Fawzi 21, Douglas A. Jabs 6, 22, David Sarraf 5, Vishali Gupta 23, ⁎ on behalf of the
Multimodal Imaging in Uveitis (MUV) Task force⁎
Alejandra de-la-Torre 24, Alejandro Fonollosa 25, Alessandro Invernizzi 26, 27, Amani Fawzi 28, Andrew Dick 29, 30, 31, Aniruddha Agarwal 32, 33, Anita Agarwal 34, 35, Antoine Brezin 36, Ariel Schlaen 37, Bahram Bodaghi 38, Claudia Fabiani 39, David Sarraf 40, Debra A. Goldstein 41, Dilraj Grewal 42, Douglas A. Jabs 43, 44, Edmund Tsui 45, Elisabetta Miserocchi 46, 47, Ester Carreño 48, Francesco Pichi 32, Ilknur Tugal-Tutkun 49, Inês Leal 50, Janet L. Davis 51, Jeanette Ossewaarde-van Norel 52, Jennifer E. Thorne 53, Jessica G. Shantha 54, Jose S. Pulido 55, Justine Smith 56, Jyotirmay Biswas 57, K. Bailey Freund 58, 59, Kathryn Pepple 60, Lee M. Jampol 61, Luca Cimino 62, 63, Marc De Smet 64, Maria Vittoria Cicinelli 47, Marion R. Munk 65, Massimo Accorinti 66, Maura Di Nicola 67, Meghan Berkenstock 53, Michael Altaweel 68, 69, Phoebe Lin 70, Quan Dong Nguyen 71, Richard Spaide 58, Rupesh Agrawal 72, 73, Sapna S. Gangaputra 74, Soon Phaik Chee 75, Srinivas Sadda 76, Sumit Sharma 56, Timothy M. Janetos 77, Vishali Gupta 78, Zohar Habot-Wilner 79
24 Neuroscience Research Group (NEUROS), Neurovitae Center for Neuroscience, Institute of Translational Medicine (IMT), School of Medicine and Health Sciences, Universidad del Rosario, Bogotá, Colombia
25 Department of Ophthalmology, Biocruces Bizkaia Health Research Institute, Cruces University Hospital, University of the Basque Country, Barakaldo, Spain
26 Eye Clinic, Department of Biomedical and Clinical Science, Luigi Sacco Hospital, University of Milan, Milan, Italy
27 Department of Ophthalmology, Save Sight Institute, University of Sydney, Sydney, Australia
28 Northwestern University Feinberg School of Medicine, Chicago, USA
29 University of Bristol, UK; Bristol Eye Hospital, UK
30 Institute of Ophthalmology, University College London, London, UK
31 National Institute for Health Research Biomedical Research Centre, Moorfields Eye Hospital, London, UK
32 Eye Institute, Cleveland Clinic, Abu Dhabi, United Arab Emirates
33 Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio, USA
34 California Pacific Medical Center (CPMC), San Francisco, CA, USA
35 West Coast Retina, San Francisco, CA, USA
36 Department of Ophthalmology, Ophtalmopôle, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, AP-HP, Université Paris Cité, 75014, Paris, France
37 Hospital Universitario Austral, Derqui-Pilar, Argentina
38 Department of Ophthalmology, IHU FOReSIGHT, Pitié-Salpêtrière Universtiy Hospital, Paris, France
39 Ophthalmology Unit, Department of Medicine, Surgery and Neurosciences, University of Siena and Azienda Ospedaliero-Universitaria Senese [European Reference Network (ERN) for Rare Immunodeficiency, Autoinflammatory, and Autoimmune Diseases (RITA) Center], Sienna, Italy
40 Stein Eye Institute, University of California, Los Angeles, California, USA
41 Department of Ophthalmology, Northwestern University Feinberg School of Medicine, Chicago, Illinois USA
42 Department of Ophthalmology, Duke University School of Medicine, Durham, NC, USA
43 Center for Clinical Trials and Evidence Synthesis, Department of Epidemiology, The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
44 Wilmer Eye Institute, Department of Ophthalmology, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
45 Stein Eye Institute, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
46 School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
47 Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Milan, Italy
48 Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
49 Department of Ophthalmology, Istanbul University, Istanbul, Turkey
50 Centro Hospitalar Universitário Lisboa Norte, Centro Académico de Medicina de Lisboa (CAML), Lisbon, Portugal
51 Department of Ophthalmology, University of Miami Miller School of Medicine, Bascom Palmer Eye Institute, Miami, FL, USA
52 University Medical Center Utrecht, Utrecht, the Netherlands
53 Wilmer Eye Institute, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
54 Francis I. Proctor Foundation, Department of Ophthalmology, University of California, San Francisco, USA
55 Wills Eye Hospital, Thomas Jefferson University Philadelphia, PA
56 College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
57 Uveitis and Ocular Pathology Department, Sankara Nethralaya, Chennai, India
58 Vitreous Retina Macula Consultants of New York, New York, USA
59 Department of Ophthalmology, NYU Grossman School of Medicine, New York, NY, USA
60 Department of Ophthalmology, University of Washington, Seattle, USA
61 Department of Ophthalmology, Northwestern University Feinberg School of Medicine, Chicago, Illinois USA
62 Ocular Immunology Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
63 Department of Surgery, Medicine, Dentistry and Morphological Sciences, with Interest in Transplants, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy
64 Micro Invasive Ocular Surgery Clinic, Lausanne, Switzerland
65 Augenarzt Praxisgemeinschaft Gutblick, Pfäffikon, Switzerland
66 IRCSS Fondazione G. B. Bietti, Rome, Italy
67 Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
68 Department of Ophthalmology and Visual Sciences, University of Wisconsin, Madison, WI, USA
69 McPherson Eye Research Institute, University of Wisconsin, Madison, WI, USA
70 Cleveland Clinic Foundation, Cole Eye Institute, Cleveland, USA
71 Spencer Center for Vision Research, Byers Eye Institute, Stanford University, Palo Alto, CA
72 National Healthcare Group Eye institute, Tan Tock Seng Hospital, Singapore
73 LKC School of Medicine, Nanyang Technological University, Singapore; Duke NUS Medical School, Singapore
74 Vanderbilt Eye Institute, Vanderbilt University Medical Center, Nashville, TN, USA
75 Department of Ocular Inflammation and Immunology, Singapore National Eye Centre, Singapore
76 Doheny Eye Institute, University of California, Los Angeles, Pasadena, California, USA
77 Department of Ophthalmology, Northwestern University Feinberg School of Medicine, Chicago, Illinois USA
78 Advanced Eye Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India
79 Tel Aviv Medical Center, Tel Aviv University, Tel Aviv, Israel
1 Vanderbilt Eye Institute (S.G.), Vanderbilt University Medical Center, Nashville, Tennessee, USA
2 Eye Institute (A.A.), Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates
3 Cleveland Clinic Lerner College of Medicine (A.A.), Cleveland, Ohio, USA
4 University Medical Center Utrecht (J.O.N.), Utrecht, the Netherlands
5 Stein Eye Institute (E.T., D.S.), David Geffen School of Medicine at UCLA, Los Angeles, California, USA
6 Department of Ophthalmology (J.E.T., D.A.J.), Wilmer Eye Institute, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
7 The Department of Epidemiology (J.E.T.), The Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
8 Neuroscience Research Group (NEUROS) (A.D.T.), Neurovitae Center for Neuroscience, Institute of Translational Medicine (IMT), School of Medicine and Health Sciences, Universidad del Rosario, Bogotá, Colombia
9 Department of Ophthalmology and Visual Sciences (M.A.), University of Wisconsin, Madison, Wisconsin, USA
10 McPherson Eye Research Institute (M.A.), University of Wisconsin, Madison, Wisconsin, USA
11 Uveitis and Ocular Pathology Department (J.B.), Sankara Nethralaya, Chennai, India
12 Doheny Eye Institute (S.S.), University of California, Los Angeles, Pasadena, California, USA
13 Department of Biomedical and Clinical Science (A.I.), Eye Clinic, Luigi Sacco Hospital, University of Milan, Milan, Italy
14 Department of Ophthalmology (A.I.), Save Sight Institute, University of Sydney, Sydney, Australia
15 National Healthcare Group Eye institute (R.A.), Tan Tock Seng Hospital, Singapore
16 LKC School of Medicine (R.A.), Nanyang Technological University, Singapore
17 Duke NUS Medical School (R.A.), Singapore, Singapore
18 Ocular Infections and AntiMicrobials (R.A.), Singapore Eye Research Institute, Singapore, Singapore
19 Department of Ophthalmology (J.G.S.), Francis I. Proctor Foundation, University of California, San Francisco, USA
20 IRCSS Fondazione G. B. Bietti (M.A.), Rome, Italy
21 Northwestern University Feinberg School of Medicine (A.F.), Chicago, USA
22 Department of Epidemiology (D.A.J.), Center for Clinical Trials and Evidence Synthesis, The Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
23 Advanced Eye Centre (V.G.), Postgraduate Institute of Medical Education and Research, Chandigarh, India
⁎Inquiries to Sapna Gangaputra, Vanderbilt Eye Institute, Nashville, Tennessee, USA.Vanderbilt Eye InstituteNashvilleUSA⁎⁎Inquiries to Vishali Gupta, Advanced Eye Center, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India.Advanced Eye CenterPost Graduate Institute of Medical Education and Research (PGIMER)Chandigarh160012India
Résumé |
PURPOSE |
To develop imaging and consensus-based guidelines on the application of multimodal imaging in noninfectious multifocal choroiditis and panuveitis (MFCPU) and punctate inner choroiditis (PIC).
DESIGN |
Consensus agreement guided by the review of literature and an expert committee using nominal group technique (NGT).
METHODS |
An expert committee applied a timed structured nominal group technique (NGT) to achieve consensus-based recommendations on specific disease characteristics, biomarkers of activity, and complications for MFCPU and PIC. Representative cases with noninfectious active and inactive MFCPU and PIC with color fundus photographs (CFP), optical coherence tomography (OCT), fundus fluorescein angiography (FFA), OCT angiography (OCTA), indocyanine angiography (ICGA), and fundus autofluorescence images (FAF) were reviewed. These recommendations were voted upon by the entire task force.
RESULTS |
The experts agreed that lesions of MFCPU and PIC can be well characterized using CFP. OCT is the preferred modality for detecting active lesions. Both FAF and OCT are effective for monitoring disease recurrence. Late-phase ICGA is most valuable in recurrent disease when the lesions are not visible on FAF and CFP. While OCTA and ICGA can successfully identify lesions and complications such as choroidal neovascularization, no imaging biomarkers were found to reliably distinguish between active and inactive lesions on these two modalities.
CONCLUSIONS |
Incorporating imaging findings, particularly OCT, into the Standardization of Uveitis Nomenclature (SUN) classification criteria for MFCPU and PIC enables more precise assessment of disease activity. These consensus-based guidelines provide a framework for selecting optimal imaging modalities for diagnosis, monitoring and identification of complications of MFCPU and PIC.
Le texte complet de cet article est disponible en PDF.Plan
© 2025
The Authors. Publié par Elsevier Masson SAS. Tous droits réservés.
Vol 276
P. 272-285 - août 2025 Retour au numéro
Article précédent
- Efficacy and Safety of Polypropylene Scleral Suture Fixation of Intraocular Lens in Pediatric Nontraumatic Ectopia Lentis: A Real-World Study
- Siyuan Liu, Xinyu Zhang, Zhenzhen Liu, Charlotte Young, Zhangkai Lian, Danying Zheng, Guangming Jin
- Comment on: Intraocular lens power calculation—comparing big data approaches to established formulas
- Mohammad Reza Baghiyan Zarchi, Mohammad Erabi, Ali Hosseini
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?