Reliability of quantitative and qualitative chorioretinal uveitis lesion analysis on blue, green, and near-infrared fundus autofluorescence and color fundus photography.

As there is a lack of reliable structural outcome parameters for posterior uveitis trials, we compared inter-rater reliability (IRR) of chorioretinal lesion area measurement (quantitative analyses) and characterization (qualitative analyses) on color fundus photography (CFP) and multimodal fundus autofluorescence (FAF). In this prospective cohort study, posterior uveitis eyes were imaged with CFP (Eidon, iCare, Vantaa), short- (swBAF, 450 nm; Eidon) and long-wavelength blue-light-autofluorescence (lwBAF, 488 nm), green-light-autofluorescence (GAF, 518 nm), and infrared-autofluorescence (IRAF, 787 nm) (all Spectralis, Heidelberg Engineering, Heidelberg). Lesion area, measured with ImageJ (National Institutes of Health), and image characteristics of lesions were graded on all modalities by two masked raters. A total of 318 lesions from 27 eyes (17 patients) were included. Absolute inter-rater differences in area measurement were 0.57, 0.78, 0.30, 0.36, and 0.55 in standardized 10 pixels for CFP, swBAF, lwBAF, GAF, and IRAF, respectively. IRR was high for all modalities for quantitative (intraclass correlation, 95% confidence interval (CI) [0.997-0.998]) and at least substantial for qualitative measures (unweighted Cohen's kappa 0.84, 0.91, 0.89, 0.91, and 0.89 for CFP, swBAF, lwBAF, GAF, and IRAF, respectively, all p < 0.0001, CIs [0.79-0.95]). Hence, FAF could be a reliable complementary imaging modality for posterior uveitis clinical trials, especially for lesion quantification.

© 2026. The Author(s).

PMID: 42225783