Sir,
My co-authors and I thank Dr Soleimani1 for his comments on our article.2 We share the same opinion regarding the possible role of an ischemia of the iris root.3, 4 The mydriasis induced by topical atropine 1% is indeed one of the possible causes of iris ischemia in the UZS. Its implication was actually suspected for many cases of UZS, including the first description of this syndrome.5, 6, 7 But these cases are anecdotal compared to the number of patients treated with atropine eye drops for anterior uveitis and who never developed any definite mydriasis. Thus, we believe that topical atropine eye drops are not sufficient enough to cause UZS. They only serve as a ‘revealer’. But it requires a prior impairment of the iris root and/or of the ciliary body due to a surgery procedure, a pathology, or some other circumstances. It is this prior impairment of the ciliary body that we attribute to cidofovir.
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Orssaud, C., Wermert, D., Roux, A. et al. Response to Dr Soleimani. Eye 28, 1385 (2014). https://doi.org/10.1038/eye.2014.167
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DOI: https://doi.org/10.1038/eye.2014.167
