Severe sequelae in bilateral acute iris transillumination syndrome secondary to the use of oral moxifloxacin: a case report
Abstract Background Moxifloxacin is a fourth-generation fluoroquinolone used as a second-line treatment for multiple bacterial infections. Uveitis has been described as an adverse effect related to this medication. Although several case reports have been published describing uveitis and bilateral ac...
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| Format: | Article |
| Language: | English |
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BMC
2021-09-01
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| Series: | Journal of Medical Case Reports |
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| Online Access: | https://doi.org/10.1186/s13256-021-03075-y |
| _version_ | 1818918229356052480 |
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| author | Nicolás Rivera-Valdivia Karla Arteaga-Rivera Juliana Reyes-Guanes Natalia Neira-Segura Alejandra de-la-Torre |
| author_facet | Nicolás Rivera-Valdivia Karla Arteaga-Rivera Juliana Reyes-Guanes Natalia Neira-Segura Alejandra de-la-Torre |
| author_sort | Nicolás Rivera-Valdivia |
| collection | DOAJ |
| description | Abstract Background Moxifloxacin is a fourth-generation fluoroquinolone used as a second-line treatment for multiple bacterial infections. Uveitis has been described as an adverse effect related to this medication. Although several case reports have been published describing uveitis and bilateral acute iris transillumination syndrome related to moxifloxacin, we present a unique case of a patient with severe sequelae associated with bilateral acute iris transillumination syndrome secondary to the use of oral moxifloxacin. Case presentation A 45-year-old Colombian hispanic female presented bilateral conjunctival hyperemia, decreased visual acuity, blurred vision, photophobia, and ocular pain after 15 days of treatment with systemic moxifloxacin for an upper tract respiratory infection. The patient presented unilateral anterior chamber pigment dispersion, mydriatic and nonreactive pupils, extensive iris transillumination defects, and secondary glaucoma. Blood and aqueous humor tests were negative for infectious and autoimmune diseases. Moxifloxacin-induced bilateral acute iris transillumination syndrome was diagnosed. Permanent sequelae such as ocular pain, photophobia, and focus difficulty secondary to severe bilateral iridian atrophy and inability of synkinetic reflex were left. Additionally, glaucoma was diagnosed, and Ahmed valve implantation was required. Conclusions We should be aware of the possible association between moxifloxacin and bilateral acute iris transillumination syndrome. A detailed anamnesis, adequate examination, and laboratory tests are necessary to reach an early diagnosis and treatment to avoid unnecessary therapies. Larger studies should be carried out to understand the pathophysiology, diagnosis, management, and sequelae of the disease. |
| first_indexed | 2024-12-20T00:46:38Z |
| format | Article |
| id | doaj.art-d6d2bd8bbe754b7bb34052632cbd26f8 |
| institution | Directory Open Access Journal |
| issn | 1752-1947 |
| language | English |
| last_indexed | 2024-12-20T00:46:38Z |
| publishDate | 2021-09-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Medical Case Reports |
| spelling | doaj.art-d6d2bd8bbe754b7bb34052632cbd26f82022-12-21T19:59:23ZengBMCJournal of Medical Case Reports1752-19472021-09-011511710.1186/s13256-021-03075-ySevere sequelae in bilateral acute iris transillumination syndrome secondary to the use of oral moxifloxacin: a case reportNicolás Rivera-Valdivia0Karla Arteaga-Rivera1Juliana Reyes-Guanes2Natalia Neira-Segura3Alejandra de-la-Torre4Escuela Barraquer Research Group, Escuela Superior de Oftalmología - Instituto Barraquer de AméricaEscuela Barraquer Research Group, Escuela Superior de Oftalmología - Instituto Barraquer de AméricaEscuela Barraquer Research Group, Escuela Superior de Oftalmología - Instituto Barraquer de AméricaEscuela Barraquer Research Group, Escuela Superior de Oftalmología - Instituto Barraquer de AméricaNeURos research group, Escuela de Medicina y Ciencias de la salud, Universidad del RosarioAbstract Background Moxifloxacin is a fourth-generation fluoroquinolone used as a second-line treatment for multiple bacterial infections. Uveitis has been described as an adverse effect related to this medication. Although several case reports have been published describing uveitis and bilateral acute iris transillumination syndrome related to moxifloxacin, we present a unique case of a patient with severe sequelae associated with bilateral acute iris transillumination syndrome secondary to the use of oral moxifloxacin. Case presentation A 45-year-old Colombian hispanic female presented bilateral conjunctival hyperemia, decreased visual acuity, blurred vision, photophobia, and ocular pain after 15 days of treatment with systemic moxifloxacin for an upper tract respiratory infection. The patient presented unilateral anterior chamber pigment dispersion, mydriatic and nonreactive pupils, extensive iris transillumination defects, and secondary glaucoma. Blood and aqueous humor tests were negative for infectious and autoimmune diseases. Moxifloxacin-induced bilateral acute iris transillumination syndrome was diagnosed. Permanent sequelae such as ocular pain, photophobia, and focus difficulty secondary to severe bilateral iridian atrophy and inability of synkinetic reflex were left. Additionally, glaucoma was diagnosed, and Ahmed valve implantation was required. Conclusions We should be aware of the possible association between moxifloxacin and bilateral acute iris transillumination syndrome. A detailed anamnesis, adequate examination, and laboratory tests are necessary to reach an early diagnosis and treatment to avoid unnecessary therapies. Larger studies should be carried out to understand the pathophysiology, diagnosis, management, and sequelae of the disease.https://doi.org/10.1186/s13256-021-03075-yDrug-related side effects and adverse reactionsMoxifloxacinBilateral acute iris transilluminationGlaucomaSequelae |
| spellingShingle | Nicolás Rivera-Valdivia Karla Arteaga-Rivera Juliana Reyes-Guanes Natalia Neira-Segura Alejandra de-la-Torre Severe sequelae in bilateral acute iris transillumination syndrome secondary to the use of oral moxifloxacin: a case report Journal of Medical Case Reports Drug-related side effects and adverse reactions Moxifloxacin Bilateral acute iris transillumination Glaucoma Sequelae |
| title | Severe sequelae in bilateral acute iris transillumination syndrome secondary to the use of oral moxifloxacin: a case report |
| title_full | Severe sequelae in bilateral acute iris transillumination syndrome secondary to the use of oral moxifloxacin: a case report |
| title_fullStr | Severe sequelae in bilateral acute iris transillumination syndrome secondary to the use of oral moxifloxacin: a case report |
| title_full_unstemmed | Severe sequelae in bilateral acute iris transillumination syndrome secondary to the use of oral moxifloxacin: a case report |
| title_short | Severe sequelae in bilateral acute iris transillumination syndrome secondary to the use of oral moxifloxacin: a case report |
| title_sort | severe sequelae in bilateral acute iris transillumination syndrome secondary to the use of oral moxifloxacin a case report |
| topic | Drug-related side effects and adverse reactions Moxifloxacin Bilateral acute iris transillumination Glaucoma Sequelae |
| url | https://doi.org/10.1186/s13256-021-03075-y |
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