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. 2018 Jul;32(7):1190-1196.
doi: 10.1038/s41433-018-0054-y. Epub 2018 Mar 2.

Bilateral acute iris transillumination following systemic administration of antibiotics

Paris Tranos  1 , Evangelos Lokovitis  2 , Stelios Masselos  3 , Nikolaos Kozeis  1 , Magda Triantafylla  1 , Nikolaos Markomichelakis  3
Affiliations

Bilateral acute iris transillumination following systemic administration of antibiotics

Paris Tranos et al. Eye (Lond). 2018 Jul.

Abstract

Objectives: To describe the demographic characteristics, clinical features, and potential prognostic factors of bilateral acute iris transillumination (BAIT) following oral antibiotic uptake.

Methods: A retrospective study of 16 consecutive patients who developed BAIT following treatment with systemic antibiotics. Detailed past medical and ocular history was obtained, presenting signs and symptoms were documented and demographic characteristics were analyzed. All patients underwent a complete ocular examination and laboratory investigation. The course of best corrected visual acuity (BCVA), anterior chamber activity, and intraocular pressure (IOP) during the follow-up period were recorded and possible correlations with potential prognosticators were investigated.

Results: Fourteen females and two males were included in the present study. The mean age (SD) of the patients was 43 (14) years. All individuals presented conjunctival injection and photophobia and developed bilateral transillumination defects, fixed mid-dilated pupils and pigment dispersion in the anterior chamber. Systemic antibiotics were previously prescribed in all cases (13 patients with moxifloxacin and three patients with clarithromycin) and the mean (SD) interval between onset of symptoms and antibiotic administration was 17 (4) days. Ocular hypertension complicated all eyes and required antiglaucoma medication in 25 eyes. Severe anterior chamber pigment dispersion and higher IOP during the first week after presentation was significantly associated with longer duration of ocular hypertension (OHT) (p = 0.019).

Conclusions: BAIT represents a rare clinical entity with characteristic features. Although etiopathogenesis of this condition remains unclear, a series of cases that indicate a strong correlation between systemic antibiotic administration and BAIT is herein presented.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Color photo of anterior segment demonstrating diffuse transillumination defects and fixed mid-dilated, irregular shaped pupil, 2 months following uptake of oral moxifloxacin
Fig. 2
Fig. 2
Mean anterior chamber pigmentary activity during the follow-up period
Fig. 3
Fig. 3
Mean IOP variations during the follow-up period. W = week, M = month
Fig. 4
Fig. 4
Anterior segment OCT: (a) Right eye, (b) Left eye, no backbowing of the iris was observed
See this image and copyright information in PMC

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