Bilateral acute depigmentation of the iris (BADI): First reported case in Brazil

Abstract

Bilateral acute depigmentation of the iris (BADI) is a recently described entitycharacterizedby acute onset of pigment dispersion in the anterior chamber, depigmentationof the iris, and heavy pigment deposition in the anterior chamberangle. Involvement is always bilateral, simultaneous, and symmetrical. We reportthe case of a 61-year-old man who presented with bilateral ocular pain, red eyes, and severe photophobia. Examination revealed a dense Krukenberg spindle, heavypigment dispersion in the anterior chamber, extensive transillumination irisdefects, and a heavy pigment deposition in the trabecular meshwork bilaterally. Intraocular pressure increased to 48 mmHg in both eyes. The patient receivedtopical steroids, maximum hypotensive treatment and oral valacyclovir. Intraocularpressure gradually decreased throughout the second and third months, andmedications were gradually tapered. The time to complete resolution of pigmentdispersion was 18 weeks. Visual acuity and visual fields remained normal, but thephotophobia was permanent.