This review integrates anatomical and physiological principles to propose a mechanism-based framework for understanding, diagnosing, and managing uveal effusion — framing it as a dynamic disruption of uveal fluid homeostasis rather than a discrete disease entity.
The review identifies key permissive factors (hypotony, venous congestion, impaired transscleral outflow) that drive uveal effusion, and highlights that effusion can be absent even with marked choroidal inflammation or hyperpermeability when these factors are missing. An imaging-driven algorithmic approach using ultrasound biomicroscopy, AS-OCT, EDI-OCT, and ultrawide-field angiography is proposed to guide compartmental localization and targeted therapy.
This is a narrative review without a systematic search or meta-analysis, so conclusions are expert-opinion-based. No original patient data or outcomes data are reported to validate the proposed framework.
Clinicians should evaluate uveal effusion by identifying its dominant mechanistic driver (vascular permeability, venous outflow resistance, scleral permeability, or IOP) rather than defaulting to empirical anti-inflammatory treatment. Multimodal imaging — especially EDI-OCT and ultrawide-field angiography — can guide compartmental diagnosis and mechanism-aligned therapy.
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