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


CONCLUSIONS
These cases suggest that moxifloxacin may interfere with the healing of corneal ulcers.
Walter
Keith
K
Wake Forest University Eye Center, Department of Ophthalmology, Winston-Salem, NC 27157, USA. kwalter@wfubmc.edu
Tyler
Marshall E
ME
D000328:Adult; D000369:Aged, 80 and over; D000890:Anti-Infective Agents / Q000008:administration & dosage / Q000009:adverse effects*; D001372:Aza Compounds / Q000008:administration & dosage / Q000009:adverse effects*; D015715:Corneal Edema / Q000139:chemically induced* / Q000473:pathology / Q000628:therapy; D016039:Corneal Transplantation; D003320:Corneal Ulcer / Q000139:chemically induced* / Q000473:pathology / Q000628:therapy; D003937:Diagnosis, Differential; D005260:Female; D024841:Fluoroquinolones / Q000008:administration & dosage / Q000009:adverse effects; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D007634:Keratitis / Q000188:drug therapy; D008297:Male; D000077266:Moxifloxacin; D009883:Ophthalmic Solutions; D011804:Quinolines / Q000008:administration & dosage / Q000009:adverse effects*
D000890:Anti-Infective Agents; D001372:Aza Compounds; D024841:Fluoroquinolones; D005938:Glucocorticoids; D009883:Ophthalmic Solutions; D011804:Quinolines; D000077266:Moxifloxacin