Severe pseudouveitis associated with moxifloxacin therapy

Introduction. - Moxifloxacin is an antibiotic of the fluoroquinolone class, marketed in France since 2002. It is used primarily in the treatment of bacterial sinusitis and acute exacerbations of chronic bronchitis. The purpose of this study is to report a possible severe ocular side effect following the systemic use of moxifloxacin. Patient and methods. - Case report of a patient who presented with the appearance of a severe acute uveitis after being treated with systemic moxifloxacin. Eleven days after initiation of moxifloxacin treatment, the patient developed simultaneous bilateral eye pain, pigment dispersion and diffuse iris transillumination. This case was further complicated by ocular hypertension. Etiologic investigations for other causes of the uveitis were negative. In particular, an anterior chamber tap was performed and PCR for herpes viruses (HSV, VZV, EBV, CMV) was negative. Discussion. - Drug-induced uveitis is relatively rare. The relationship between systemic fluoroquinolone treatment and the occurrence of uveitis has been considered "possible'', according to World Health Organization criteria, in a recent retrospective analysis of 40 case reports. Moxifloxacin was suspected in 25 of these cases. The presence of both iris transillumination and pigment dispersion appears specific to the uveitis in question. Conclusion. - It appears that practitioners prescribing moxifloxacin and ophthalmologists should be informed of this possible adverse effect, so that it may be quickly recognized, managed and reported. (C) 2012 Elsevier Masson SAS. All rights reserved.