Bilateral acute depigmentation of the iris (BADI) and bilateral acute iris transillumination (BAIT): A case series from a center in Brazil

Arq Bras Oftalmol. 2024 Apr 19;87(4):e2023. doi: 10.5935/0004-2749.2023-0219. eCollection 2024.

Abstract

Bilateral acute depigmentation of the iris and bilateral acute iris transillumination (BAIT) are similar clinical entities. The former causes acute-onset depigmentation of the iris stroma without transillumination, whereas the latter causes depigmentation of the iris pigment epithelium with transillumination. The etiopathogenesis of these conditions is not yet fully understood, but the proposed causes include the use of systemic antibiotics (especially moxifloxacin) and viral triggers. We present a case series of five female patients with a mean age of 41 (32-45) years, all of whom suffered acute onset of bilateral pain and redness of the eyes after moxifloxacin use (oral or topical). It is important for ophthalmologists to be aware of the two forms of iris depigmentation since this case series suggests that SARS-CoV-2 or its empirical treatment with moxifloxacin may trigger iris depigmentation. If this is the case, clinicians will likely see increased incidences of bilateral acute depigmentation of the iris and bilateral acute iris transillumination during and after the COVID-19 pandemic.

Publication types

  • Case Reports

MeSH terms

  • Acute Disease
  • Adult
  • Anti-Bacterial Agents / adverse effects
  • Brazil
  • COVID-19* / complications
  • Female
  • Humans
  • Iris / pathology
  • Iris Diseases* / chemically induced
  • Middle Aged
  • Moxifloxacin / adverse effects
  • Moxifloxacin / therapeutic use
  • Pigment Epithelium of Eye / drug effects
  • Pigment Epithelium of Eye / pathology
  • Pigmentation Disorders / chemically induced
  • SARS-CoV-2
  • Transillumination

Substances

  • Moxifloxacin
  • Anti-Bacterial Agents