Standardization of Retinal Vasculitis Terminology With Consensus Definitions From a Delphi Panel
JAMA OPHTHALMOLOGY, 2026 (SCI-Expanded, Scopus)
- Publication Type: Article / Article
- Publication Date: 2026
- Doi Number: 10.1001/jamaophthalmol.2026.2957
- Journal Name: JAMA OPHTHALMOLOGY
- Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, BIOSIS, CINAHL, EMBASE, MEDLINE, Biomedical Reference Collection: Corporate Edition (EBSCO), Health Research Premium Collection (ProQuest)
- Istanbul University Affiliated: Yes
Abstract
This Delphi consensus study investigates if standardized consensus-based definitions are associated with an improvement in the terminology and classification of retinal vasculitis and related retinal vascular inflammatory conditions. QuestionAre standardized consensus-based definitions associated with an improvement in the terminology and classification of retinal vasculitis and related retinal vascular inflammatory conditions?FindingsIn this international Delphi consensus study involving 27 experts in ophthalmology, rheumatology, pathology, imaging, and methodology, consensus was achieved for standardized definitions of retinal vasculitis and related entities, including vascular leakage, retinal perivasculitis, retinal vasculopathy, and infectious and noninfectious retinal vasculitis.MeaningResults of this study suggest that these consensus definitions may improve consistency in clinical communication, research reporting, imaging interpretation, and future development of standardized diagnostic and artificial intelligence-based approaches for retinal vascular inflammatory disease. ImportanceRetinal vasculitis is a sight-threatening condition associated with diverse ocular and systemic diseases. Variability in terminology and definitions across clinical practice and research has limited diagnostic consistency, communication among specialists, and comparability of studies.ObjectiveTo develop standardized, consensus-based definitions for retinal vasculitis and related terms to improve diagnostic clarity and harmonize communication among ophthalmologists and other medical specialties.Design, Setting, and ParticipantsThis was an international modified Delphi consensus study conducted using a structured consensus process guided by a comprehensive literature review, including systematic reviews and meta-analyses. Two rounds of Delphi surveys were performed, and consensus was predefined as at least 75% agreement. Included was an international expert panel of 27 specialists in ophthalmology, rheumatology, pathology, imaging, and research methodology. The specialists had recognized expertise in retinal and systemic vasculitis, retinal imaging, or consensus methodology. Study data were analyzed from March to September 2025.ExposureParticipation in a structured Delphi process evaluating proposed definitions and terminology related to retinal vasculitis and associated vascular inflammatory entities.Main Outcomes and MeasuresConsensus definitions for retinal vasculitis and related entities, with agreement using predefined consensus thresholds.ResultsA total of 27 international experts participated in the Delphi process. After 5 executive committee members involved in developing preliminary definitions were excluded from voting to minimize bias, a total of 22 independent experts completed both Delphi rounds. All candidate statements exceeded the predefined consensus threshold in the first round (agreement range, 83.3%-95.5%), although some demonstrated variability in the strength of agreement. After refinement of definitions, consensus strengthened in the second round, with agreement levels ranging from 95.2% to 100%. The panel established consensus definitions for 8 terms: retinal vasculitis, vascular leakage, infectious retinal vasculitis, noninfectious retinal vasculitis, retinal perivasculitis, retinal vasculopathy, primary retinal vasculitis, and far-peripheral vascular leakage. These definitions were developed to distinguish vascular leakage from true vasculitis, clarify inflammatory and noninflammatory vascular disorders, and promote consistent terminology across clinical practice and research.Conclusions and RelevanceThis international Delphi consensus established standardized nomenclature for retinal vasculitis and related vascular inflammatory entities. Adoption of these definitions may improve diagnostic accuracy, facilitate interpretation of imaging findings, enhance consistency across clinical studies, and support future research efforts, including the development of artificial intelligence-based classification systems for retinal vascular disease.