Corneal plaque containing levofloxacin in a dog

Area of Science:

• Veterinary Ophthalmology
• Ophthalmology
• Pharmacology

Background:

• Corneal ulcers are a common complication following ocular surgery.
• Intracapsular lens extraction (ICLE) is a surgical procedure for cataracts.
• Topical fluoroquinolones are frequently used to treat bacterial eye infections.

Observation:

• A Yorkshire terrier developed a corneal ulcer post-ICLE, treated with levofloxacin eye drops.
• A white, lustrous corneal plaque formed during levofloxacin treatment.
• The corneal plaque exhibited antimicrobial activity against Escherichia coli.

Findings:

• Levofloxacin was confirmed within the corneal plaque using MALDI-TOF/TOF mass spectrometry.
• Surgical removal of the plaque and switching to tobramycin eye drops led to complete corneal ulcer resolution.
• This case demonstrates a rare instance of corneal plaque formation from topical levofloxacin.

Implications:

• Topical levofloxacin, despite its solubility, can potentially cause corneal deposits.
• Ophthalmologists should be aware of this rare adverse drug reaction in veterinary patients.
• Further research may be needed to understand the mechanisms of fluoroquinolone-induced corneal deposits.