Fuchs uveitis syndrome in a patient with primary myelofibrosis: a case report
Medical hypothesis, discovery & innovation in optometry,
Vol. 7 No. 3 (2026),
31 October 2026
,
Page 146-153
https://doi.org/10.51329/mehdioptometry255
Abstract
Background: Fuchs uveitis syndrome (FUS) is a chronic, typically unilateral, low-grade anterior uveitis characterized by diffuse stellate keratic precipitates, iris stromal atrophy, heterochromia, cataract, and vitreous inflammation. Primary myelofibrosis (PMF) is a chronic myeloproliferative neoplasm associated predominantly with thromboembolic, hemorrhagic, and infiltrative ocular manifestations, whereas inflammatory uveitic presentations are exceedingly uncommon. We report a rare coexistence of FUS in a patient with PMF and discuss potential shared inflammatory mechanisms.Case Presentation: A 64-year-old Asian Indian man with a 2-year history of PMF, receiving oral prednisolone and hydroxyurea, presented with a 2-month history of decreased vision in the left eye (OS). Bone marrow evaluation evidenced hypercellular marrow with megakaryocytic proliferation and reticulin fibrosis, while next-generation sequencing identified pathogenic variants involving JAK2, TET2, and SH2B3. Best-corrected distance visual acuity was 20/20 in the right eye (OD) and 20/25 in the OS, with normal intraocular pressure in both eyes. Slit-lamp examination of the OS revealed diffuse stellate keratic precipitates, minimal anterior chamber flare, iris sphincter atrophy, and grade-2 nuclear sclerosis with posterior subcapsular cataract, whereas the OD was unremarkable. No posterior synechiae or posterior segment abnormalities were identified. Based on the characteristic unilateral clinical findings, a diagnosis of FUS was established. Systemic evaluation for infectious and granulomatous causes of uveitis, including chest radiography, Mantoux testing, Treponema pallidum hemagglutination assay, and serum angiotensin-converting enzyme levels, was unremarkable. The patient was treated with topical nepafenac ophthalmic suspension and subsequently underwent uneventful phacoemulsification with posterior chamber intraocular lens implantation in the OS, achieving a postoperative visual acuity of 20/20. Over 3.5 years of follow-up, the eye remained clinically quiescent, with stable visual acuity and no evidence of recurrent inflammation or secondary glaucoma.
Conclusions: This case describes a previously unreported occurrence of FUS in a patient with PMF. Although a causal relationship cannot be established from a single case, this coexistence highlights the importance of careful ophthalmic evaluation and clinical documentation of atypical unilateral chronic anterior uveitis in patients with myeloproliferative neoplasms. Further studies are warranted to clarify the potential relationship between PMF and FUS.
- Fuchs uveitis syndrome
- primary myelofibrosis
- anterior uveitis
- cataracts
- case report
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