Non-Infectious Anterior Uveitis Is Associated with Functional Retinal Changes Demonstrable by Multifocal Electroretinography

Introduction: Although anterior non-infectious uveitis affects the structures of the anterior segment of the eye, (inflammatory) disruption of the hemato–ocular barrier may lead to changes in the structures of the posterior segment of the eye. Objective: To evaluate functional retinal changes using multifocal electroretinography (mfERG) and their relationship with structural optical coherence tomography (OCT) parameters in patients with acute anterior non-infectious uveitis (AANU). Methods: This prospective study included 38 eyes of 19 patients diagnosed with unilateral AANU and age-matched healthy fellow eyes as controls. All subjects underwent comprehensive ophthalmological examination, including best-corrected visual acuity (BCVA), spectral-domain OCT, and mfERG testing at baseline, 3 months, and 6 months. mfERG parameters (amplitude and implicit times) were analyzed alongside central field thickness (CFT), macular volume (MV), and average macular thickness (AMT). Results: Eyes affected by AANU demonstrated a significant reduction in mfERG response amplitude in the central retinal region compared with control eyes, particularly during the acute phase. Although OCT parameters showed partial structural normalization during follow-up, functional recovery was less pronounced in selected retinal regions. Latency values showed minimal variation over time. These findings indicate a potential dissociation between electrophysiological function and structural morphology during disease resolution. Conclusions: Acute anterior uveitis is associated with measurable macular functional impairment detectable by mfERG, even when structural OCT parameters appear relatively stable. These results suggest that inflammatory processes in AAU may extend beyond the anterior segment and transiently affect retinal function. mfERG may therefore serve as a sensitive adjunct tool for detecting and monitoring subclinical macular dysfunction in AANU. Clinical Relevance: Functional retinal impairment may persist despite apparent structural recovery in acute anterior uveitis. Incorporating mfERG into clinical evaluation may improve the detection of subtle macular involvement and enhance understanding of disease dynamics beyond conventional imaging findings.