Corneal deposits secondary to rifabutin

Corneal Deposits in a Patient With Anti–Interferon-γ Autoantibody Syndrome

“…In a study of children who were HIV positive and taking rifabutin for MAC prophylaxis, treatment duration was associated with a greater likelihood of deposit formation . In another case report, a patient with recurrent MAC infection developed corneal deposits during his second round of rifabutin therapy. During a third course, the deposits increased in density and appeared centrally.…”

“…Rifabutin-associated corneal deposits are described as having a stellate or polymorphous shape, peripheral location, and yellow-white or yellow-brown color. 2 In all reports, including cases with involvement of the central cornea, the deposits are visually insignificant. 2 Although most drug-related corneal deposits occur in the epithelium or stroma, rifabutin-associated deposits have been described as endothelial.…”

“…2 In all reports, including cases with involvement of the central cornea, the deposits are visually insignificant. 2 Although most drug-related corneal deposits occur in the epithelium or stroma, rifabutin-associated deposits have been described as endothelial. 3 To our knowledge, there is only 1 case report of in vivo confocal microscopy of these lesions in which the authors localized the deposits to the deep stroma.…”

“…Most case reports have involved patients with compromised immune systems, either because of HIV infection, pharmacologic immunosuppression for the treatment of autoimmune disease, or, as we now report, anti-interferon-γ autoantibody syndrome. 2 While these reports raise the question of an association between the drug deposits and a compromised immune system, MAC infections requiring long-term rifabutin therapy occur nearly exclusively in immunosuppressed individuals. 10 Therefore, it is not clear that immunosuppression plays a directly causal role in the development of these deposits.…”

“…Although uveitis is a well-known toxic effect of rifabutin, irreversible corneal deposits have also been reported. Rifabutin-associated corneal deposits are described as having a stellate or polymorphous shape, peripheral location, and yellow-white or yellow-brown color . In all reports, including cases with involvement of the central cornea, the deposits are visually insignificant .…”