Anterior segment optical coherence tomography in uveitis: A comprehensive review of clinical applications, diagnostic insights, and future directions

Anterior segment optical coherence tomography (AS-OCT) is emerging as an essential tool in the diagnosis and monitoring of uveitis. Offering noninvasive, high-resolution imaging, AS-OCT allows clinicians to visualize and quantify subtle changes in the anterior chamber (AC), iris, cornea, sclera, and lens that may be difficult to capture with slit-lamp examination alone. We highlight how AS-OCT improves the detection of AC cells and flare, supports disease monitoring through automated, reproducible metrics, and facilitates care in challenging settings, such as pediatric uveitis or clinical trials. In the cornea, AS-OCT allows detailed evaluation of keratic precipitates and subclinical endothelial dysfunction. It also provides disease-specific metrics of iris thickness and surface smoothness in conditions such as Fuchs uveitis syndrome. In the sclera, AS-OCT can distinguish episcleritis from scleritis, differentiate their subtypes, and monitor inflammation resolution. Emerging applications, including anterior vitreous imaging and artificial intelligence-driven analysis, suggest a growing role for AS-OCT in personalized care. As evidence expands, AS-OCT is poised to become a cornerstone of multimodal imaging in uveitis, enhancing precision, reducing subjectivity, and improving outcomes for patients across a wide spectrum of inflammatory eye disease.