Acute iris depigmentation following systemic moxifloxacin
Abstract
Dear Editor,
Quinolones were first introduced in 1962, and their excellent oral absorption, good tissue distribution in tissue, and urinary concentrations, which exceed the minimum inhibitory concentration for many common pathogens, popularized their use in routine clinical practice. Structural modifications of quinolones resulted in improved pharmacokinetics, with a longer elimination half-life, which permitted once-daily dosing and improved tissue penetration. For this reason and many others, fourth generation compounds, such as moxifloxacin, are increasingly being prescribed (1,2).
Moxifloxacin is licensed to treat acute bacterial sinusitis, acute bacterial exacerbation of chronic bronchitis, community acquired pneumonia, complicated and uncomplicated skin and skin structure infections, and complicated intra-abdominal infections. In 2007, moxifloxacin ranked 140th among the top 200 drugs prescribed in the United States, and it has proven to be a blockbuster drug, generating billions of dollars in revenue. In 2007 alone, Avelox® generated $697.3 million in sales worldwide (2).
In ophthalmology, moxifloxacin is widely prescribed as eye drops to treat infectious keratitis and as a postoperative prophylactic regimen during cataract surgery. It is also injected intraocularly to prevent and treat intraocular infections (3).
Acute depigmentation of the iris is a new clinical condition that is characterized by an acute onset of pigment dispersion in the anterior chamber,…
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