Ocular angiography: dual FA/ICGA scoring of posterior uveitis

Summary In the recent past uveitis has become an exact clinical science thanks, among others, to the availability of performing imaging methods. The SUN process (standardization of uveitis nomenclature) should have been the forum where these new imaging modalities should have been integrated. However SUN did just the opposite, perpetuating old and obsolete measurement methods. For the evaluation of posterior uveitis they recommended the more than 30 year old vitreous haze scoring system comparing vitreous haze to a set of 4 pictures with increasing grades of vitreous haze, recommending it as the gold standard and main outcome measure for clinical trials on new treatments in posterior uveitis. This method is subjective and has a scale of only 4 grades, improper to reach statistical significance even in cases with pronounced vitritis. Dual FA/ICGA angiography allows scoring of both retinal and choroidal inflammation with scales of respectively 40 for each. Such a numbered measurement modality is by far more adequate to measure posterior uveitis as it scores both the retinal and choroidal inflammation in entities that mostly have limited vitreitis. Several studies will illustrate the central role of FA/ICGA in monitoring posterior uveitis.