Rapid corneal adrenochrome deposition from topical ibopamine in the setting of infectious keratitis

Sir,

Owing to its ability to act as both a direct and indirect sympathomimetic agonist, topical ibopamine has been used to treat chronic refractory hyptotony.¹ Ibopamine is rapidly hydrolyzed by corneal esterases to epinine, which then undergoes the same in vivo oxidation process as epinephrine to form adrenochromes. In acidic mediums, ischemic environments, and in the presence of reactive oxygen species adrenochrome becomes unstable and can undergo autooxidation to its melanin degradation products.^{2, 3} Although corneal pigmentation from topical epinephrine has been observed,⁴ and such depositions have been reported on a Boston keratoprosthesis with the use of ibopamine,⁵ such deposition from ibopamine has not, to our knowledge, been reported in the cornea itself.

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