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      Bilateral Lipid Keratopathy in the Setting of Brimonidine Tartrate Use

      case-report

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          Abstract

          Lipid keratopathy (LK) is a rare disease involving lipid deposition in the cornea resulting in corneal opacification. Primary LK can arise sporadically while secondary LK is seen in patients with a history of ocular trauma, medication exposure, infection, inflammation, or disorders resulting in derangements of lipid metabolism. Secondary LK is more common and occurs due to neovascularization. Use of precipitating medications should be considered in LK workup, particularly for patients in whom other etiologies have been ruled out. Brimonidine, an ocular hypotensive medication, can be associated with LK. We present a case of bilateral secondary LK in a patient with a history of prolonged brimonidine use, without additional contributing factors.

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          Most cited references15

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          Subconjunctival and intracorneal bevacizumab injection for corneal neovascularization in lipid keratopathy.

          The purpose of this study was to evaluate the efficacy and safety of subconjunctival and corneal intrastromal bevacizumab injections on corneal neovascularization in patients with lipid keratopathy. Three eyes of 3 patients with lipid keratopathy accompanied by corneal neovascularization received at least 2 subconjunctival and corneal intrastromal injections of bevacizumab (1.25 mg/0.05 mL, respectively) at 1-month intervals. Ophthalmic examinations, including visual acuity, tonometry, slit lamp biomicroscopy, and corneal topography, were performed before injection and every month thereafter. All patients had marked regression of corneal neovascularization. Reduction in lipid deposition was noted in one patient. There were no adverse ocular or systemic events, except for a small intracorneal hemorrhage noted in one patient, which quickly and spontaneously cleared. Subconjunctival and intracorneal bevacizumab is a well-tolerated and effective method for obliterating corneal neovascularization in lipid keratopathy.
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            Photodynamic therapy for corneal neovascularisation and lipid degeneration.

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              Severe Corneal Disorders Developed After Brimonidine Tartrate Ophthalmic Solution Use.

              The primary side effects associated with 0.1% brimonidine tartrate (BT) ophthalmic solution with sodium chlorite are allergic conjunctivitis, blepharitis, and conjunctival hyperemia. However, cornea-related side effects are rare. In this study, we report 2 similar cases in which corneal neovascularization, corneal infiltration, and corneal opacity developed after BT eye-drop use.
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                Author and article information

                Contributors
                Journal
                Case Rep Ophthalmol Med
                Case Rep Ophthalmol Med
                CRIOPM
                Case Reports in Ophthalmological Medicine
                Hindawi
                2090-6722
                2090-6730
                2023
                17 April 2023
                : 2023
                : 8115622
                Affiliations
                1Hoopes Vision Research Center, Hoopes Vision, 11820 S. State St. #200, Draper, UT, USA
                2John A. Moran Eye Center, University of Utah School of Medicine, 65 Mario Capecchi Dr, Salt Lake City, UT 84132, USA
                3Utah Lions Eye Bank, 6056 Fashion Square Dr Suite 2000, Murray, UT 84107, USA
                4University of Texas Health Science Center at Houston, McGovern Medical School, 6431 Fannin St, Houston, TX 77030, USA
                5Case Western Reserve University School of Medicine, 9501 Euclid Ave, Cleveland, OH, USA
                6Arizona College of Osteopathic Medicine, Midwestern University, Ocotillo Hall, 19555 59th Ave, Glendale, AZ 85308, USA
                Author notes

                Academic Editor: Stephen G. Schwartz

                Author information
                https://orcid.org/0000-0003-1024-6250
                https://orcid.org/0000-0002-1836-5388
                https://orcid.org/0000-0003-2893-7033
                https://orcid.org/0000-0003-2545-9312
                https://orcid.org/0000-0002-8852-4380
                https://orcid.org/0000-0002-2567-8331
                Article
                10.1155/2023/8115622
                10125731
                0263ff90-f544-4392-ac3d-88422c932b71
                Copyright © 2023 Majid Moshirfar et al.

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 17 October 2022
                : 17 March 2023
                : 21 March 2023
                Categories
                Case Report

                Ophthalmology & Optometry
                Ophthalmology & Optometry

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