Durch Moxifloxacin-Augentropfen induziertes Hornhautödem

Purpose. This case report describes a case of acute unilateral central corneal edema in a patient undergoing treatment with topical moxifloxacin 0.5% ophthalmic solution for bacterial keratitis secondary to contact lens wear. Material and Methods. During a problem-focused exam of an acute red eye, clinical examination with a Haag Streit slit lamp and sodium fluorescein dye revealed a 3 × 3 mm corneal ulcer and associated anterior chamber reaction in the left eye. The patient was started on moxifloxacin 0.5% ophthalmic solution q1h OS and cyclopentolate 1% TID OS. On day 3, there was 95% re-epithelialization of the corneal ulcer and significant improvement in symptoms. Unexpectedly, the patient’s best corrected visual acuity in the left eye deteriorated from baseline due to new onset central corneal edema. Moxifloxacin was discontinued and the patient was started on ciprofloxacin 0.3% ophthalmic solution QID OS and instructed to return to office in 2 days for follow-up. Results. On day 5, there was complete epithelialization of the corneal ulcer with a resolving subepithelial infiltrate. The central stromal edema and anterior chamber reaction were completely resolved. Conclusion. Acute corneal stromal edema is a possible side-effect of topical moxifloxacin use. Eye care providers must be aware of this potential side-effect when making therapeutic decisions for bacterial keratitis treatment.