Bilateral Acute Iris Transillumination Syndrome Following Oral Moxifloxacin Overdose.

We report a case of bilateral acute iris transillumination (BAIT) syndrome caused by an overdose of oral moxifloxacin in a Hispanic female patient with no previous respiratory viral infection. A 56-year-old Hispanic female with no history of ocular illness was referred to our glaucoma service to manage her microcystic edema, swelling, and refractory ocular hypertension. Her ocular and systemic symptoms, including progressively worsening bilateral ocular pain, severe photophobia, blurred vision, nausea, and vomiting, started 14 days after an accidental overdose of oral moxifloxacin. Moxifloxacin had been prescribed to treat a complicated urinary tract infection. A slit-lamp examination revealed bilateral microcystic corneal edema and transillumination in the right temporal iris, both consistent with a diagnosis of BAIT syndrome. The existing literature on BAIT syndrome is scarce, and its etiology remains unclear. This case provides clinical evidence supporting moxifloxacin toxicity as a possible cause of BAIT syndrome. We emphasize the importance of conducting extensive research to define the mechanisms involved in moxifloxacin-induced BAIT syndrome and to search for other potential etiologies of this condition.

Aflibercept as a Treatment for Secondary Central Serous Chorioretinopathy in a Patient With Myasthenia Gravis.

We report on a case of central serous chorioretinopathy (CSCR) secondary to chronic steroid use that showed sustained improvement when treated with an aflibercept intravitreal injection. A 44-year-old woman presented with decreased visual acuity of the left eye (OS). The patient had a recent history of myasthenia gravis and was being treated with systemic corticosteroids and immunosuppressants. At presentation, her visual acuity was 20/80 OS; an examination (using fluorescein angiography) of the left fundus revealed a serous retinal detachment of the posterior pole that extended to the mid-periphery and multiple areas of leakage, which findings were consistent with CSCR. The patient also had a history of unresolved strabismic amblyopia in her right eye. The patient's CSCR was managed with one injection of intravitreal aflibercept (2 mg/0.05 mL). One month following treatment, her visual acuity improved to 20/20 OS, and the serous retinal detachment had resolved. Ten months following treatment, an examination revealed a sustained improvement, with a visual acuity of 20/20 OS. Concomitantly, the patient's amblyopic eye revealed an improved visual acuity of 20/20. Our case suggests that some cases of secondary CSCR may respond to treatment with intravitreal aflibercept. This case also suggests that the CSCR imposed a unique form of occlusion therapy that helped improve the amblyopia of the contralateral eye in this adult patient.

SPECTROSCOPIC AND ELECTROCHEMICAL PROPERTIES OF 2-AMINOPHENOTHIAZINE.

Phenothiazines derivatives are versatile compounds that are used in many fields, depending on the type and position of the substitution on the parent molecule. The photochemical, photophysical and electrochemical properties of several phenothiazine derivatives have been previously reported in detail. However, no reports have been presented for 2-aminophenothiazine (APH), a candidate that provides for the further chemical modification and the introduction of specific substituents. In this work, the photophysical and electrochemical properties of APH were measured in acetonitrile. The APH ground state absorption and fluorescence spectrum (phi(f) < 0.01) are similar to the corresponding that of PH parent molecule. A mono exponential decay fluorescence lifetime of 0.65 ns was determined for APH in acetonitrile. Characterization of the 355 nm nanosecond laser flash photolysis transient species reveals the presence of the triplet-triplet transient intermediate with a high intersystem crossing quantum yield (phi(T) = 0.72 +/- 0.07), indicating that the APH main excited state deactivation channel is intersystem crossing. The oxidation potential of APH is lower than phenothiazine parent molecule ((0.38 V vs 0.69 V vs Ag/AgCl(sat)). Altogether, these results show that APH has photochemical and photophysical properties similar to the phenothiazine parent molecule, but with the possibility of providing an amino functionality at 2-position for further chemical modification.