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Idoxuridine-induced conjunctival cicatrization.
Archives of Ophthalmology (Chicago, Ill. : 1960)
|May 1, 1983
Summary
Idoxuridine, used for eye infections, can cause conjunctival scarring similar to ocular cicatricial pemphigoid. This condition, affecting only the treated eye, can lead to significant vision loss and corneal damage.
Area of Science:
- Ophthalmology
- Dermatology
Background:
- Ocular cicatricial pemphigoid (OCP) is a chronic autoimmune disease causing inflammation and scarring of the conjunctiva.
- Herpes simplex keratitis and Sjögren's syndrome are conditions that can affect the ocular surface.
Observation:
- Four patients developed conjunctival cicatrization resembling OCP exclusively in the eye treated with idoxuridine (IDU).
- Three patients had a history of recurrent herpes simplex keratitis, and one had Sjögren's syndrome.
- Treatment involved topical idoxuridine and corticosteroids over extended periods.
Findings:
- Idoxuridine treatment led to significant ocular morbidity, including visual loss, stromal ulceration, corneal scarring, and keratinization.
- Conjunctival biopsies revealed cicatrization with inflammation but lacked specific autoimmune markers.
- Immunofluorescence studies were negative for autoantibodies in both conjunctival tissue and circulation.
Implications:
- Idoxuridine can induce a cicatrizing conjunctival reaction mimicking OCP, independent of autoimmune processes.
- This highlights the potential for antiviral medications to cause severe ocular surface disease.
- Clinicians should consider drug-induced cicatrization in patients presenting with symptoms similar to OCP after topical ocular medication use.