Harada Kohei, Uematsu Masafumi, Ueki Ryotaro, Kusano Mao, Yamada Yoshihisa, Mohamed Yasser Helmy, Kitaoka Takashi
Department of Ophthalmology and Visual Sciences, Graduate School of Biomedical Sciences, Nagasaki University, Japan.
Medicine (Baltimore). 2020 May 22;99(21):e20049. doi: 10.1097/MD.0000000000020049.
Rifabutin is a broad-spectrum antibiotic known to cause deposits on the corneal endothelium and lens. We report a patient in whom cataracts developed and progressive pigment deposits were seen on the corneal endothelium, lens, and iridocorneal angle.
The patient was a 45-year-old woman who had been received long-term treatment with a combination of various anti-mycobacterial drugs for multidrug-resistant tuberculosis starting in 2004. Rifabutin was started in 2009, and she was referred to our department in 2017 for detailed ophthalmological examination.
Both eyes showed pigmented deposits over the entire corneal endothelium, the entire periphery of the iridocorneal angle, and the anterior surface of the lens. Mild cataracts were also diagnosed bilaterally. Pigment deposits on the anterior surface of the lens and the cataracts in both eyes gradually progressed. These lesions were assumed to be associated with long term rifabutin intake.
Rifabutin intake was discontinued after progression of intraocular deposits, cataracts, and ERG deterioration.
Visual acuity improved, although cataracts, deposits, and ERG deterioration remained.
Rifabutin may induce not only corneal endothelial deposits, but also cataracts and iridocorneal angle deposits.
利福布汀是一种广谱抗生素，已知会导致角膜内皮和晶状体出现沉积物。我们报告了一名患者，其出现了白内障，并且在角膜内皮、晶状体和虹膜角膜角发现了进行性色素沉着。
该患者为一名45岁女性，自2004年起开始接受多种抗分枝杆菌药物联合治疗耐多药结核病。2009年开始使用利福布汀，2017年转诊至我科进行详细眼科检查。
双眼角膜内皮全层、虹膜角膜角全周及晶状体前表面均有色素沉着。双侧还诊断出轻度白内障。晶状体前表面的色素沉着和双眼白内障逐渐进展。这些病变被认为与长期服用利福布汀有关。
眼内沉积物、白内障进展及视网膜电图恶化后停用利福布汀。
视力有所改善，尽管白内障、沉积物和视网膜电图恶化仍存在。
利福布汀不仅可能诱发角膜内皮沉积物，还可能诱发白内障和虹膜角膜角沉积物。
