BILATERAL ACUTE IRIS TRANSILLUMINATION (BAIT): A RARE SYNDROME POSSIBLY ASSOCIATED WITH COVID-19 AND MOXIFLOXACIN USE. A REPORT OF 2 CASES.

To raise awareness on BAIT and its possible association with COVID-19 and moxifloxacin use. 

Bilateral acute iris transillumination (BAIT) is a rare clinical entity, presumed to be associated with preceding upper respiratory tract infection and/or use of certain antibiotics, marked by bilateral acute loss of iris pigment epithelium with pigment dispersion in the anterior chamber and trabecular meshwork, which can cause elevated intraocular pressure and glaucoma, and with iris transillumination and sphincter paralysis which lead to photophobia and blurry vision. We report the first two cases of BAIT in our center which both had a history of preceding COVID-19 (coronavirus disease 2019) and moxifloxacin use.

A case report of two patients diagnosed with BAIT describing their medical history, characteristics and clinical examination finidings.

Since both patients developed symptoms a few weeks after COVID-19, as well as since previously published reports showed a possible association with upper respiratory infections being triggers, an association of BAIT syndrome with the SARS-CoV-2 infection is suspected. Both patients were treated with fluoroquinolone moxifloxacin, which is by itself associated with BAIT. However, it is interesting to notice that we had no diagnosed cases of BAIT before the COVID-19 pandemic, even though Croatia was ranked 7th on the consumption of quinolones among 20 European Union/European Economic Area countries in 2017.

With more awareness, ophthalmologists might diagnose more cases, and thus gain more information regarding the link between COVID-19 and BAIT, which might be underdiagnosed since it is rare or easily misdiagnosed as some more common diseases with similar features.