Ultra-Widefield Indocyanine Green Angiography in Uveitis

PURPOSE: This study aims to define the added value of ultra-widefield indocyanine green angiography (UWF-ICGA) in the evaluation of uveitis. METHODS: A retrospective, observational study was conducted on patients with posterior uveitis, panuveitis, or secondary vasoproliferative tumors evaluated between January 2020 and October 2025. All patients underwent UWF-ICGA using the Optos Silverstone device. The primary outcome was the percentage of eyes showing lesions extending beyond the vortex veins. RESULTS: A total of 343 eyes with uveitis were included in the study. UWF-ICGA revealed pathological findings located beyond the vortex veins in 245 eyes (71.4%). Specifically, extreme peripheral involvement was detected in 100% of cases with ampiginous choroiditis and vasoproliferative tumors. In serpiginous choroiditis, multifocal choroiditis, serpiginous-like choroiditis, Vogt-Koyanagi-Harada disease and birdshot chorioretinitis, peripheral lesions were identified in 11.1%, 43.8%, 69.2%, 73.6% and 93.9% of cases, respectively. CONCLUSION: UWF-ICGA expands diagnostic capabilities in uveitis by enabling detailed assessment of peripheral retinochoroidal involvement, often missed with conventional imaging. Its integration into clinical practice enhances detection of inflammatory activity, may influence therapeutic decisions, and supports more accurate disease monitoring.