- Letter to the Editor
- Open Access
Moxifloxacin and bilateral acute iris transillumination
© Knape et al.; licensee Springer. 2013
- Received: 10 September 2012
- Accepted: 12 September 2012
- Published: 14 January 2013
Recent publications have alerted clinicians to a syndrome of uveitic transilluminating iris depigmentation associated with systemic fluoroquinolones and other antibiotics. Bilateral acute iris transillumination, which is associated with loss of the iris pigment epithelium and results in iris transillumination, differs from the previously described bilateral acute depigmentation of the iris, which is associated with atrophy of the iris stroma without transillumination. We present a case of fluoroquinolone-associated uveitis with anterior segment optical coherence tomography imaging to highlight some observations about this syndrome. We interpret pharmacokinetic data to help explain why oral, but not topical, moxifloxacin may cause fluoroquinolone-associated uveitis.
- Iris transillumination
- Pigment dispersion
Recent publications have alerted clinicians to a syndrome of transilluminating iris depigmentation associated with the use of systemic fluoroquinolones and other antibiotics [1, 2]. This syndrome, termed bilateral acute iris transillumination by some authors , differs from the previously described bilateral acute depigmentation of the iris, which causes reversible atrophy of the iris stroma without iris transillumination . In contrast, fluoroquinolone-associated uveitis preferentially targets the iris pigment epithelium, leading to irreversible iris transillumination .
We present a case of fluoroquinolone-associated uveitis with anterior segment optical coherence tomography (OCT) imaging to highlight some observations about this syndrome. We interpret pharmacokinetic data to help explain why oral, but not topical, moxifloxacin may cause fluoroquinolone-associated uveitis. We also discuss the possible impact of the presence of the native crystalline lens. Finally, we note that the anterior segment OCT findings suggest that both the iris stroma and iris pigment epithelium are affected in fluoroquinolone-associated uveitis.
The authors wish to acknowledge Brandon M. Sparling, CRA, for the photographic contributions. This study is supported by the NIH Center Core Grant P30EY014801, Research to Prevent Blindness Unrestricted Grant, and the Department of Defense (DOD, grant no. W81XWH-09-1-0675).
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