Department of Ophthalmology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
Department of Ophthalmology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
BMJ Case Rep. 2020 Jun 30;13(6):e233528. doi: 10.1136/bcr-2019-233528.
A 56-year-old paramedic was admitted to hospital and treated for severe pneumonia. Shortly after initiating antibiotic treatment (including moxifloxacin), he developed bilaterally painful eyes and was diagnosed with bilateral acute anterior uveitis (AAU). Three years later, he was referred to the ophthalmology clinic with bilateral iris transillumination suggesting iris atrophy and limited pupillary dilation, indicating iris sphincter muscle paralysis. AAU typically presents unilaterally. An onset of bilateral AAU is unusual and warrants investigation for underlying systemic cause. The fluoroquinolone moxifloxacin has been reported in a limited number of cases as a causative agent of bilateral AAU and iris atrophy. This case provides additional supporting evidence that moxifloxacin may cause degradation of collagen and iris muscle in the eye, as well as elsewhere in the body, such as in blood vessels. Additionally, we present novel anterior segment ocular imaging (using optical coherence tomography) demonstrating the ability to detect iris atrophy using non-invasive imaging.
一位 56 岁的护理人员因严重肺炎住院并接受治疗。在开始使用抗生素治疗（包括莫西沙星）后不久，他的双眼出现疼痛，并被诊断为双侧急性前葡萄膜炎（AAU）。三年后，他因双侧虹膜光透射提示虹膜萎缩和瞳孔扩张受限而被转至眼科诊所，这表明虹膜括约肌瘫痪。AAU 通常单侧发作。双侧 AAU 的发作不常见，需要调查潜在的系统性病因。氟喹诺酮类药物莫西沙星在少数情况下被报道为双侧 AAU 和虹膜萎缩的致病剂。本病例提供了更多支持证据，表明莫西沙星可能导致眼睛和身体其他部位（如血管）的胶原和虹膜肌肉降解。此外，我们还展示了新颖的前段眼部成像（使用光学相干断层扫描），证明了使用非侵入性成像检测虹膜萎缩的能力。
