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Mendez Bermudez IJ, Ramirez Marquez E, Ayala Rodríguez SC, Ruiz-Justiz AJ, Rodriguez-Garcia EJ, Gonzalez M, Nieves I, Blasini M, Santos C, Oliver AL. Bilateral Acute Iris Transillumination Syndrome Following Oral Moxifloxacin Overdose. Cureus 2023; 15:e47426. [PMID: 38022122 PMCID: PMC10658970 DOI: 10.7759/cureus.47426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/21/2023] [Indexed: 12/01/2023] Open
Abstract
We report a case of bilateral acute iris transillumination (BAIT) syndrome caused by an overdose of oral moxifloxacin in a Hispanic female patient with no previous respiratory viral infection. A 56-year-old Hispanic female with no history of ocular illness was referred to our glaucoma service to manage her microcystic edema, swelling, and refractory ocular hypertension. Her ocular and systemic symptoms, including progressively worsening bilateral ocular pain, severe photophobia, blurred vision, nausea, and vomiting, started 14 days after an accidental overdose of oral moxifloxacin. Moxifloxacin had been prescribed to treat a complicated urinary tract infection. A slit-lamp examination revealed bilateral microcystic corneal edema and transillumination in the right temporal iris, both consistent with a diagnosis of BAIT syndrome. The existing literature on BAIT syndrome is scarce, and its etiology remains unclear. This case provides clinical evidence supporting moxifloxacin toxicity as a possible cause of BAIT syndrome. We emphasize the importance of conducting extensive research to define the mechanisms involved in moxifloxacin-induced BAIT syndrome and to search for other potential etiologies of this condition.
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Affiliation(s)
- Israel J Mendez Bermudez
- Ophthalmology, University of Puerto Rico School of Medicine, Medical Sciences Campus, San Juan, USA
| | | | - Sofía C Ayala Rodríguez
- Ophthalmology, University of Puerto Rico School of Medicine, Medical Sciences Campus, San Juan, USA
| | - Armando J Ruiz-Justiz
- Ophthalmology, University of Puerto Rico School of Medicine, Medical Sciences Campus, San Juan, USA
| | | | - Monica Gonzalez
- Ophthalmology, University of Puerto Rico School of Medicine, Medical Sciences Campus, San Juan, USA
| | - Ileana Nieves
- Ophthalmology, University of Puerto Rico School of Medicine, Medical Sciences Campus, San Juan, USA
| | - Marino Blasini
- Ophthalmology, University of Puerto Rico School of Medicine, Medical Sciences Campus, San Juan, USA
| | - Carmen Santos
- Ophthalmology, University of Puerto Rico School of Medicine, Medical Sciences Campus, San Juan, USA
| | - Armando L Oliver
- Ophthalmology, University of Puerto Rico School of Medicine, Medical Sciences Campus, San Juan, USA
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Khachikian SS, Jones ME. Comment on: Relative efficacy of intracameral moxifloxacin injection methods. J Cataract Refract Surg 2023; 49:1079-1080. [PMID: 37769176 DOI: 10.1097/j.jcrs.0000000000001261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/30/2023]
Affiliation(s)
- Stephen S Khachikian
- From the Black Hills Regional Eye Institute, Rapid City, South Dakota (Khachikian); University of South Dakota Sanford School of Medicine, Sioux Falls, South Dakota (Jones)
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Oraby MF, Alrashidi SA, Hagras SM. Bilateral Acute Iris Transillumination without Prior Systemic Antibiotics. J Curr Ophthalmol 2022; 34:469-473. [PMID: 37180524 PMCID: PMC10170978 DOI: 10.4103/joco.joco_93_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 05/17/2022] [Accepted: 05/17/2022] [Indexed: 05/16/2023] Open
Abstract
Purpose To describe a case of bilateral acute iris transillumination (BAIT) with no history of systemic infections or antibiotics intake before the attack. Methods This study included the review of the clinical record of the patient. Results A 29-year-old male was referred to the glaucoma clinic with presumed bilateral acute iridocyclitis with refractory glaucoma. Ophthalmic examination revealed bilateral pigment dispersion, marked iris transillumination, dense pigment deposition in the iridocorneal angle, and high intraocular pressure. The patient was diagnosed with BAIT and was followed for 5 months. Conclusion The diagnosis of BAIT can be elicited even without a prior history of systemic infection or antibiotics intake.
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Affiliation(s)
| | | | - Sherein Mahmoud Hagras
- Department of Ophthalmology, Farwaniya Hospital, Kuwait
- Address for correspondence: Sherein Mahmoud Hagras, Department of Ophthalmology, Farwaniya Hospital, Kuwait. E-mail:
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