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The following is a summary of “Evidence and Consensus-Based Imaging Guidelines in Multifocal Choroiditis with Panuveitis and Punctate Inner Choroiditis – Multimodal Imaging in Uveitis (MUV) Taskforce Report 5,” published in the April 2025 issue of American Journal of Ophthalmology by Gangaputra et al. 

Researchers conducted a retrospective study to develop imaging and consensus-based guidelines for the application of multimodal imaging in noninfectious multifocal choroiditis and panuveitis (MFCPU) and punctate inner choroiditis (PIC).  

They used a timed, structured nominal group technique (NGT) with an expert committee to reach consensus-based recommendations on disease characteristics, biomarkers of activity, and complications for noninfectious MFCPU and PIC. Representative cases of active and inactive noninfectious MFCPU and PIC were reviewed, including color fundus photographs (CFP), optical coherence tomography (OCT), fundus fluorescein angiography (FFA), OCT angiography (OCTA), indocyanine angiography (ICGA), and fundus autofluorescence images (FAF). These recommendations were then voted on by the entire task force.  

The results showed that lesions of noninfectious MFCPU and PIC were well characterized using CFP. The OCT was identified as the preferred modality for detecting active lesions. Both FAF and OCT were effective in monitoring disease recurrence. Late-phase ICGA proved most valuable in recurrent disease when lesions were not visible on FAF and CFP. While OCTA and ICGA successfully identified lesions and complications such as choroidal neovascularization, no imaging biomarkers reliably distinguished between active and inactive lesions in these 2 modalities.  

Investigators concluded that integrating imaging findings, especially OCT, into the Standardization of Uveitis Nomenclature (SUN) classification criteria for MFCPU and PIC allowed for a more accurate evaluation of disease activity, and these agreed-upon guidelines offered a structure for choosing the best imaging techniques for diagnosing, monitoring, and detecting complications of MFCPU and PIC. 

Source: ajo.com/article/S0002-9394(25)00195-3/fulltext