Bilateral acute depigmentation of iris: 3-year follow-up of a case

Abstract

Bilateral acute depigmentation of the iris (BADI) usually affecting young women, is a newly defined clinical diagnosis with bilateral symmetrical pigment loss of iris stroma without iris transillumination defect. Herein, we want to share the results of a 3-year-long follow-up of a 23-year old female patient with BADI. She was admitted to our clinic with a complaint of discoloration of both her brown irises. An ocular evaluation of the patient revealed symmetrical pigment deposition in trabecular meshwork. No iris transillumination defect, pupillary sphincter paralysis, keratic precipitates, and inflammatory reaction in anterior chamber were seen. The depigmented iris stroma became repigmented symmetrically after 3-year follow-up period. Although it is rare, BADI should be considered in the differential diagnosis of the diseases with bilateral iris depigmentation.

Surgical Management of Glaucoma Secondary to Bilateral Acute Iris Transillumination: A Role for Gonioscopy-assisted Transluminal Trabeculotomy

“…self-limited with resolution of iris depigmentation and no effect on intraocular pressure (IOP). [1,3,4] BAIT also produces pigment in the AC but is characterized by TIDs, variable pupillary sphincter paralysis, and an increased likelihood for IOP elevation. [2] Seventy-nine cases of BAIT have been reported in the literature since the first description of the syndrome in 2004.…”

Causes of Iris Depigmentation in Young and Middle Age. Clinical Example

“…Исследования, проведенные после открытия синдрома BADI, касаются дифференцирования данного состояния со следующими заболеваниями и состояниями: гетерохромный иридоциклит Фукса, вирусный иридоциклит, вызванный ВПГ и ЦМВ, синдром дисперсии пигмента и псевдоэксфолиативная глаукома, синдром двусторонней острой трансиллюминации радужки (BAIT), впервые описанный также Tugal-Tutkun и соавт. как и синдром BADI [8,9]. К дифференциально-диагностическими критериям гетерохромного иридоциклита Фукса относятся односторонний характер поражения, который определяется у подавляющего числа пациентов, а также наличие преципитатов на роговице [10].…”

Commentary: Bilateral acute depigmentation of iris

“…Usually, BAIT is resistant to medical treatment and needs surgical glaucoma interventions,[7] which a clinician needs to decipher in the long term. Human leukocyte antigen (HLA) B-51 positive individuals have a genetic predisposition[8] to develop moxifloxacin-induced BAIT. This can be applied in real-time practice, if feasible.…”