Rifabutin corneal deposits in a patient with acquired immunodeficiency syndrome: in vivo confocal microscopy investigation.

Abstract

PURPOSE:

To establish the real localization of rifabutin-related corneal deposits in a patient with human immunodeficiency virus (HIV) infection by in vivo HRT II confocal microscopy with related clinicopathologic implications.

METHODS:

Observational case report. After Siena University Institutional Review Board approval in May 2008 and specific informed consent, a 54-year-old patient with HIV infection under rifabutin treatment for acquired immunodeficiency syndrome-related Mycobacterium avium complex prevention who developed diffuse corneal deposits was examined at the Department of Ophthalmology of Siena University. He underwent a complete clinical eye examination, biomicroscopy, and digital slit lamp photographs, endothelial specular microscopy, ultrasound pachymetry, and confocal microscopy by HRT II system.

RESULTS:

Confocal scans revealed the presence of deep stromal and pre descemetic hyperreflective polymorphous deposits. In vivo confocal examination excluded the presence of rifabutin-related deposits at endothelial level.

CONCLUSIONS:

Confocal microscopy enables establishment of the real localization of rifabutin deposits at deep stromal level, providing a better qualitative analysis of all corneal layers compared to biomicroscopic examination, with clinical and physiopathologic implications.

• Authors: Cosimo Mazzotta, Claudio Traversi, Elisabetta Nuti, Maria Caterina Sparano, Aldo Caporossi
• Journal: European journal of ophthalmology (Eur J Ophthalmol) 2009 May-Jun Vol. 19 Issue 3 Pg. 481-3 ISSN: 1120-6721 [Print] United States
• PMID: 19396800 (Publication Type: Case Reports, Journal Article)

Chemical References

• Anti-Bacterial Agents
• Anti-HIV Agents
• Rifabutin

Topics

• Anti-Bacterial Agents (adverse effects, therapeutic use)
• Anti-HIV Agents (therapeutic use)
• Corneal Diseases (chemically induced, diagnosis)
• Corneal Stroma (drug effects, pathology)
• HIV Infections (complications, drug therapy)
• Humans
• Male
• Microscopy, Confocal
• Middle Aged
• Mycobacterium avium-intracellulare Infection (prevention & control)
• Rifabutin (adverse effects, therapeutic use)