Posters

A case of bilateral rubescent cataracts in a patient with active pulmonary tuberculosis being treated with rifampicin

Poster Details

First Author: L.Bourke IRELAND

Co Author(s): E. O’Connell                    

Abstract Details

Purpose:

To describe the rare case of rubescent cataracts in a patient with active pulmonary tuberculosis being treated with rifampicin. Although red discolouration of bodily fluids and structures such as urine, teeth and tears by rifampicin has been well described, there doesn’t appear to be any case reports in the literature relating to red cataracts and rifampicin. We wish to investigate if a correlation exists between the use of rifampicin and the development of rubescent cataracts.

Setting:

Cork University Hospital, Ophthalmology department, Cork, Ireland.

Methods:

Case presentation of a 73-year-old gentleman who presented for review to our clinic with reduced vision in both eyes on a background of active pulmonary tuberculosis being treated with rifampicin.  Bilateral rubescent cataracts were noted with only a moderate reduction in visual acuity.  Bilateral extra-capsular cataract extraction (ECCE) was performed and the lens was sent for biochemical evaluation to test for rifampicin levels within the lens.

Results:

Distribution of the drug rifampicin is high throughout the body and reaches high concentrations in many organs and bodily fluids. Up to 90% of rifampicin is bound to proteins in the plasma. Although the lens lacks a direct blood delivery, growth factors and nutrients are absorbed from surrounding fluid.  We hypothesise that the red discolouration of our patients lens was due to the presence of rifampicin and aim to prove this by biochemical evaluation of extracted lens material.

Conclusions:

Due to the red-orange colour of the drug rifampicin and its metabolites, it has the ability to stain bodily fluids such as tears and urine and also structures such as the teeth. We believe that there may also be a correlation between rubescent cataracts and the use of rifampicin.

Financial Disclosure:

None