This review offers a comprehensive synthesis of current evidence on near-infrared autofluorescence (NIR-AF) in non-infectious uveitis, highlighting its strengths, limitations, and role in diagnosis, monitoring, and understanding disease mechanisms. Unlike blue-light autofluorescence, which mainly detects lipofuscin, NIR-AF visualizes melanin and related compounds in the retinal pigment epithelium (RPE) and choroid, providing deeper penetration, reduced phototoxicity, and greater comfort. Across entities like Vogt-Koyanagi-Harada disease, MEWDS, punctate inner choroidopathy, APMPPE, and Fuchs' heterochromic iridocyclitis, NIR-AF reveals patterns often invisible on conventional imaging-detecting subclinical lesions, differentiating active from inactive disease, and tracking RPE changes over time. Its persistence in showing hypoautofluorescent or hyperautofluorescent lesions after clinical resolution offers unique insight into residual or subclinical inflammation. The technique complements OCT, fluorescein, and indocyanine green angiography, adding a melanin-specific layer to multimodal imaging. Limitations include a weaker signal compared to BL-AF, susceptibility to media opacities, equipment-dependent variability, and lack of standardized interpretation criteria. While it cannot quantify choroidal melanin loss directly and image acquisition can be challenging, its non-invasive, repeatable nature and diagnostic yield make it a promising tool for longitudinal uveitis care. Further prospective studies, standardization, and AI-driven analysis could expand its clinical impact, potentially cementing NIR-AF as an essential component in uveitis imaging strategies.

We report a rare coexistence of Pellucid Marginal Degeneration (PMD) and Fuchs' heterochromic iridocyclitis (FHI) in a 40-year-old female. The overlap of corneal ectasia and chronic uveitis created significant diagnostic and surgical challenges, highlighting the importance of individualized planning in complex anterior segment diseases. The patient presented with painless, progressive visual decline in the right eye. Clinical examination revealed inferior corneal thinning, mature cataract, pigmented keratic precipitates, and peripheral anterior synechiae (PAS). Corneal tomography confirmed PMD with a characteristic "crab-claw" pattern. The patient underwent phacoemulsification with posterior chamber intraocular lens implantation. Postoperatively, visual acuity improved, although optic disc cupping and persistent PAS underscored the need for long-term glaucoma surveillance. The coexistence of PMD and FHI is exceptionally rare. PMD complicates surgical planning by affecting keratometric reliability and corneal biomechanics, while FHI contributes to cataract formation, intraocular inflammation, and risk of secondary glaucoma. Multimodal imaging, tailored surgical strategy, and vigilant postoperative follow-up are key to optimizing outcomes. Simultaneous PMD and FHI represent a unique clinical entity requiring comprehensive assessment and individualized management. Tailored surgical planning and vigilant surveillance are essential to preserve vision and mitigate long-term risks.

The aim of this study was to determine ultrasound biomicroscopic findings in patients with Fuchs uveitis syndrome (FUS). This cross-sectional, contralateral comparative eye study was conducted on patients with unilateral FUS. Both eyes of each patient underwent ultrasound biomicroscopy (UBM) imaging at the 12, 3, 6, and 9-o'clock radial meridians. Ultrasonographic data were collected, including the thickness (mm) of the ciliary body (CB), CB with ciliary processes, and iris thickness at 0.8 mm from the iris root, mid-iris, and iris tip. We enrolled 36 eyes from 18 patients with unilateral FUS, including 10 (55.6%) females, with a mean age of 38.44 ± 9.2 years. The average thickness of CB (P < 0.001), 0.8 mm from the iris root (P = 0.003), mid-iris (P < 0.001), and the iris tip (P < 0.001) was thinner in the affected eyes compared to the fellow eyes of the patients. Analysis of variance analysis showed that differences among all quadrants were not significant in both groups (P > 0.05). This study showed that CB and iris thickness were significantly thinner in the affected eyes compared to the fellow eyes of patients with FUS, as assessed using the UBM technique.

To investigate the subfoveal retinal and choroidal thickness in patients with unilateral Fuchs Uveitis Syndrome (FUS). This comparative contralateral study was performed in affected eyes with FUS versus fellow eyes. For each eye parameters such as subfoveal choroidal thickness (SCT), subfoveal choriocapillary thickness (SCCT), central macular thickness (CMT), and central macular volume (CMV) were measured; then the measured values of affected and fellow unaffected eye were compared. Thirty-seven patients (74 eyes) including 19 females (51.4%) with a mean age of 36.9 ± 7.6 years were enrolled. The mean SCT was lower in the affected eyes (344.51 ± 91.67) than in the fellow (375.59 ± 87.33) with adjusting for duration of disease and axial lengths (P < 0.001). The mean SCCT, CMT, and CMV were higher in eyes with FUS than in fellow eyes (P < 0.05). The result of our study demonstrated that affected eyes in patients with FUS tend to have thinner SCT and thicker SCCT and CMT compared to uninvolved fellow eyes.