Severe corneal toxicity after topical fluoroquinolone therapy: report of two cases

Cornea. 2006 Aug;25(7):855-7. doi: 10.1097/01.ico.0000224642.43601.14.

Abstract

Purpose: To describe 2 cases of sterile corneal ulcers that persisted after several weeks of therapy with topical moxifloxacin 0.5% but that resolved when antibiotic therapy was changed.

Methods: Small case series.

Results: Both cases presented here describe corneal ulcers that persisted and showed signs of worsening during weeks of frequent topical dosing with moxifloxacin. Descemet folds and an atypically large amount of stromal edema were present in both cases, and there appeared to be possible endothelial dysfunction as well. There was no sign of bacterial, viral, or fungal infection in either case. In both cases, healing began a few days after moxifloxacin was discontinued, and topical gatifloxacin and corticosteroids were initiated.

Conclusion: These cases suggest that moxifloxacin may interfere with the healing of corneal ulcers.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Aged, 80 and over
  • Anti-Infective Agents / administration & dosage
  • Anti-Infective Agents / adverse effects*
  • Aza Compounds / administration & dosage
  • Aza Compounds / adverse effects*
  • Corneal Edema / chemically induced*
  • Corneal Edema / pathology
  • Corneal Edema / therapy
  • Corneal Transplantation
  • Corneal Ulcer / chemically induced*
  • Corneal Ulcer / pathology
  • Corneal Ulcer / therapy
  • Diagnosis, Differential
  • Female
  • Fluoroquinolones / administration & dosage
  • Fluoroquinolones / adverse effects
  • Follow-Up Studies
  • Glucocorticoids / administration & dosage
  • Glucocorticoids / therapeutic use
  • Humans
  • Keratitis / drug therapy
  • Male
  • Moxifloxacin
  • Ophthalmic Solutions
  • Quinolines / administration & dosage
  • Quinolines / adverse effects*

Substances

  • Anti-Infective Agents
  • Aza Compounds
  • Fluoroquinolones
  • Glucocorticoids
  • Ophthalmic Solutions
  • Quinolines
  • Moxifloxacin