Corneal deposits following topical moxifloxacin use

Alshamrani, Abdulaziz A; Alharbi, Saad S.

doi:10.1016/j.sjopt.2018.04.006

Cited by 8 publications

(3 citation statements)

References 8 publications

(14 reference statements)

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“… 19 Additionally, there is a single report of corneal precipitate formation in a patient using moxifloxacin every 2 h for 38 days after corneal collagen cross linking. 20 Clinically, fluoroquinolone precipitates tend to appear within the first few days of treatment, 14 , 16 , 17 , 19 resolve within days of drug cessation, 16 but can persist for weeks to months. 14 , 16 , 17 , 19 In some cases, they have required surgical debridement.…”

Section: Discussionmentioning

confidence: 99%

Topical cenegermin associated ocular surface and contact lens drug precipitate deposit formation

White

Affeldt

2022

American Journal of Ophthalmology Case Reports

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Section: Discussionmentioning

confidence: 99%

Topical cenegermin associated ocular surface and contact lens drug precipitate deposit formation

White

Affeldt

2022

American Journal of Ophthalmology Case Reports

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“…Chalky white precipitate and crystalline patterns within epithelial defects have been described with topical fluoroquinolones. While ciprofloxacin drops and ointment are most commonly implicated,77 reports of deposits from topical moxifloxacin,78 norfloxacin,79 ofloxacin,80 tosufloxacin,81 sparfloxacin82 and gatifloxacin83 have been published as well. Furthermore, topical heparin may cause cornea verticillata 76.…”

Section: Drug Classes Overviewmentioning

confidence: 99%

Drug-induced corneal deposits: an up-to-date review

2022

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This review assesses different clinical aspects of the various known drug-induced corneal deposits, based on the corneal layer involved (epithelium, stroma and/or endothelium), and based on the drug class. The most well-known condition caused by drug deposits is vortex keratopathy, or corneal verticillata, which is a whorl-like opacity in the corneal epithelium. Vortex keratopathy is commonly caused by certain cationic amphiphilic drugs such as amiodarone, antimalarials, suramin, tamoxifen, chlorpromazine and non-steroidal anti-inflammatory drugs. These deposits usually occur once a certain dose of the drug is reached. Most cases present with mild to moderate symptoms with minimal visual impairment. Most of these deposits resolve automatically, after months to years of drug cessation. Notably, other drug classes can cause deposits in all three layers of the cornea. Chlorpromazine, gold, rifabutin, indomethacin and tyrosine kinase inhibitors can cause stromal deposits, with reduced visual acuity when the anterior stroma is involved. Chlorpromazine and rifabutin can also cause deposits in the endothelial layer of the cornea. Regardless of the type of corneal deposit, local therapies such as topical lubricants or corticosteroids may help improve symptoms. Drug cessation or modification can also be helpful but should be weighed against the systemic risks of the underlying disease.

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“…Fluoroquinolones are fluorinated derivatives of nalidixic acid and are broad-spectrum antimicrobial agents. Corneal deposits have been reported with topical administration of various fluoroquinolones including, ciprofloxacin,1–3 ofloxacin,4 gatifloxacin,5 sparfloxacin,6 moxifloxacin,7,8 and tosufloxacin 9,10. Herein, three cases of drug deposition in cornea post-penetrating keratoplasty (PK) have been reported.…”

Section: Introductionmentioning

confidence: 99%

<p>Corneal deposition of fluoroquinolones after penetrating keratoplasty: case series</p>

Sitaula

Singh

2019

IMCRJ

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Purpose: To report three cases of fluroquinolone deposition in the cornea after topical administration post-penetrating keratoplasty. Case reports: Herein we report three patients ranging in age from 42–65 years who underwent keratoplasty with cataract extraction, with intraocular lens implantation in the first two cases and left aphakic due to a posterior capsular tear in the third case. The first two patients received ciprofloxacin-dexamethasone combination drops, and developed drug deposition, which was observed at the first follow-up after 7 and 10 days respectively. The third patient received prednisolone acetate and ofloxacin eyedrops postoperatively, and developed drug deposits in the cornea after 20 days. In all of the three patients, the fluroquinolone group of drugs was discontinued and the cornea cleared gradually over the next 3–4 weeks. Although the cornea cleared, the first two grafts failed due to recurrent viral infection in one case, and graft rejection in the other case. Conclusion: Deposition of many different fluroquinolones in the cornea has been reported after a variety of surgeries, including penetrating keratoplasty. Drug deposition post-penetrating keratoplasty may seem innocuous due to self-resolution on cessation of the drugs, but it may have deleterious effects on graft survival. Hence, fluroquinolones, especially ciprofloxacin, should be cautiously used in patients undergoing penetrating keratoplasty if frequent dosing is prescribed or if used concurrently with other topical medications containing preservatives.

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Corneal deposits following topical moxifloxacin use

Cited by 8 publications

References 8 publications

Topical cenegermin associated ocular surface and contact lens drug precipitate deposit formation

Topical cenegermin associated ocular surface and contact lens drug precipitate deposit formation

Drug-induced corneal deposits: an up-to-date review

<p>Corneal deposition of fluoroquinolones after penetrating keratoplasty: case series</p>

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