Abstract: Anterior chamber-associated immune deviation (ACAID) is the primary manifestation of ocular immune privilege. It mainly involves the roles of antigen-presenting cells and regulatory T cells to inhibit systemic immune responses against intraocular antigens. The underlying mechanisms are complex, relying not only on the normal anatomical structure and physiological functions of the eye but also involving dynamic immune regulatory processes and humoral balance. Recent research has revealed more molecular mechanisms related to ACAID, such as the roles of immune checkpoint molecules and their impact on immune tolerance. Moreover, studies of ACAID mechanisms have demonstrated its potential applications in preventing graft rejection and treating autoimmune eye diseases. These research findings provide new perspectives on understanding the process of ocular immune privilege and are of significant importance in developing novel anti-inflammatory and immunotherapeutic approaches.  (Int Rev Ophthalmol, 2024, 48: 364-370)

Key words: anterior chamber-associated deviation, immune privilege, immunosuppressive microenvironment, regulatory T cell