Unilateral Acute Iris Transillumination (UAIT) Related to Topical Moxifloxacin
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Purpose
To report two cases of unilateral acute iris transillumination in patients under moxifloxacin topical treatment.
Methods
Bilateral acute iris transillumination (BAIT) or depigmentation has been described in the literature, primarily associated with systemic fluoroquinolones and other antibiotics. We present two cases of topical fluoroquinolone-associated UAIT.
Results
Case 1: A 43 year-old female patient, receiving topical moxifloxacin and dexamethasone after photorefractive keratectomy, presented with red eye and photophobia. OS examination revealed 3+ pigmented cells, posterior synechiae, pepper-like deposits on the anterior iris surface and ocular hypertension despite topical and systemic medications. Viral PCR testing was negative. Thereafter, she developed diffuse iris transillumination and a marked heterochromia.
Case 2: A 37-year-old male was referred to our clinic with a history of a corneal ulcer following a traumatic eye injury. He had been treated with topical moxifloxacin for six weeks due to recurrent epithelial erosions. Subsequently, he developed heterochromia, and was diagnosed with uveitis, prompting his physician to refer him to our care. At the initial visit, OD examination revealed diffuse iris atrophy with pepper-like deposits on the iris anterior surface and slight iris transillumination, no anterior chamber cells and normal intraocular pressure.
Conclusion
Early reports documented BAIT with systemic treatments, suggesting that topical treatment might not achieve sufficient drug levels in ocular tissues. In our patients, an epithelial barrier defect could explain the increased penetration and triggering of this syndrome.
Conflict of interest
No
1
Last name
GARCIA
Initials of first name(s)
MM
Department
Ophthalmology
City
Buenos Aires
Country
Argentina
2
Last name
Montoya
Initials of first name(s)
J
Department
Ophthalmology
City
Buenos Aires
Country
Argentina
3
Last name
Tapia
Initials of first name(s)
C
Department
Ophthalmology
City
Buenos Aires
Country
Argentina
4
Last name
Soler
Initials of first name(s)
T
Department
Ophthalmology
City
Buenos Aires
Country
Argentina
5
Last name
Bursztyn
Initials of first name(s)
M
Department
Ophthalmology
City
Buenos Aires
Country
Argentina
6
Last name
Schlaen
Initials of first name(s)
A
Department
Ophthalmology
City
Buenos Aires
Country
Argentina
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