AI and Gene Therapy as the Next Frontier for Uveitis

The use of artificial intelligence (AI) and taking a ‘cross-sciences’ research approach holds the key to unlocking better treatment pathways for uveitis, according to Andrew Dick BSc.

He said uveitis is now on the cusp of major treatment progress, particularly in sustained disease control with fewer systemic side effects. This will be achieved by taking an increasingly individualised treatment approach, using better targeted agents to treat earlier-detected disease, and the eventual introduction of gene therapy into uveitis treatment protocols.

Evolution of treatment

“Despite being a leading cause of preventable blindness, uveitis remains underdiagnosed and undertreated. However, we have made significant inroads, treatment-wise, in the last two decades,” Professor Dick said.

Historically, treatment for uveitis has relied heavily on the use of corticosteroids, but they carry the risk of both short-term and long-term side effects and increased morbidity and mortality rates, he noted.

“We know steroids are fantastic at inducing remission of acute inflammation, but you shouldn’t have patients on them for longer than three months as they start accruing side effects, with a change of mood and looks [in the short term],” he said. “Furthermore, the longer-term data is deeply worrying on cardiovascular, diabetes, and osteoporosis risks, as well as increased glaucoma and cataracts.”

However, increased disease understanding, particularly around cytokine inflammatory pathways, and recent advancements in treatment have significantly improved outcomes in uveitis. The use of disease-modifying antirheumatic drugs as first-line therapy, as well as biologic therapies (e.g., anti-TNF drugs such as adalimumab) for patients with severe or recurrent cases of uveitis, has proven highly effective. While these treatments mark a significant step forward, ensuring global access, optimising treatment protocols for the best responses, and predicting nonresponders remains a challenge, Prof Dick acknowledged.

“There has certainly been a lot of progress, [but] there is a lot more to do. Among the key things we need to do are to identify patients that are going to fail current, very successful treatments, particularly anti-TNFs,” he told EuroTimes. “We know about 30–40% of patients do not respond adequately to anti-TNF therapies, but why is this? We need to know from the get-go who those patients are and [whether they] have the necessary biomarkers to predict treatment response.”

Prof Dick and others are currently working on trying to identify the molecular and cellular signature driving patients’ individual uveitis disease. “If we can find that, then we could offer them better treatment earlier, so they don’t fail their first treatment.”

His talk stressed the importance of a tailored treatment approach depending on the cause of the inflammation driving the uveitis, as different subtypes require specific management strategies. While non-infectious uveitis often involves immunosuppressive medications to control inflammation, infectious cases must be treated with targeted antimicrobial therapies.

“By tailoring treatment approaches, we can significantly decrease the likelihood of vision loss, which is the most serious potential outcome of untreated eye inflammation,” Prof Dick said.

The need for a multidisciplinary approach

Prof Dick also strongly advocated for a multidisciplinary approach to managing uveitis, as it is frequently linked to underlying systemic diseases. Collaboration between ophthalmologists, rheumatologists, and infectious disease specialists is essential to ensuring patients receive comprehensive care and improving earlier detection and targeted treatment, he said.

Regarding research, he highlighted the advantages of taking a ‘cross-sciences’ approach to tackling the remaining uveitis challenges.

Prof Dick is a co-investigator on CLUSTER, a consortium between four institutions in the UK bringing together expertise in immunology, clinical and genomic medicine, bioinformatics, and AI through computer science to define distinct juvenile idiopathic arthritis-associated uveitis ‘endotypes’ or ‘strata’ that reflect treatment response and disease course.

“Now we are engaging much more with computational biologists and mathematicians, and we are bringing in deep learning and artificial intelligence because we need to unravel a huge amount of data—patient or biological data—that we are getting from the lab or patient.”

Beyond the ongoing development of “far better targeted treatments”, the next frontier of uveitis treatment will be gene therapy, Prof Dick explained. Ongoing research aims to refine vector designs, delivery methods, and patient selection criteria to maximise benefits and minimise risks.

“We are pushing really hard,” Prof Dick said. “We are now in the process of developing a human-ready gene therapy and will see where we get to. There have been some setbacks, but we are close.”

All these ongoing advancements mean the future is bright for uveitis treatment, Prof Dick concluded.

Prof Dick presented the Annual Mooney Lecture during the 2025 Irish College of Ophthalmologists (ICO) annual conference in Kilkenny on ‘Evolution of Treatment Regimens for Uveitis’.

Andrew Dick BSc, FRCOphth is Director of the Institute of Ophthalmology at University College London and Professor of Ophthalmology at the University of Bristol, UK. A.Dick@bristol.ac.uk