title: Bisphosphonate-associated orbital inflammation--a case report and review.
abstract: Bisphosphonates are becoming more widespread as indications for them broaden. Several ocular side effects due to bisphosphonates have been described, among the most potentially serious of which is orbital inflammation. Thirteen case reports of this side effect exist in the literature, with an additional case reported here. The most common presenting signs are lid edema, conjunctival hyperemia, and chemosis, while common symptomatology includes pain, diplopia, and blurry vision. A concomitant anterior uveitis is present in 30% of cases, and some degree of bilaterality is also seen in 30% of cases. There are two reported instances of profound visual loss, highlighting the importance of prompt recognition and treatment of this entity. Despite a paucity of rechallenge data, available reports suggest that development of orbital inflammation does not necessarily exclude patients from future bisphosphonate use.
authors.affiliation: Oculoplastic and Orbital Surgery Service, Wills Eye Institute, Philadelphia, PA 19107, USA. jpete123456789@gmail.com
authors.forename: Jared D
authors.initials: JD
authors.lastname: Peterson
authors.forename: Edward H
authors.initials: EH
authors.lastname: Bedrossian
mesh_terms: D050071:Bone Density Conservation Agents / Q000009:adverse effects*; D004164:Diphosphonates / Q000009:adverse effects*; D004487:Edema / Q000139:chemically induced / Q000175:diagnosis; D058447:Eye Pain / Q000139:chemically induced / Q000175:diagnosis; D005141:Eyelid Diseases / Q000139:chemically induced / Q000175:diagnosis; D005260:Female; D006801:Humans; D007093:Imidazoles / Q000009:adverse effects*; D007262:Infusions, Intravenous; D008875:Middle Aged; D016727:Orbital Pseudotumor / Q000139:chemically induced* / Q000175:diagnosis; D015663:Osteoporosis, Postmenopausal / Q000188:drug therapy; D014057:Tomography, X-Ray Computed; D014606:Uveitis, Anterior / Q000139:chemically induced / Q000175:diagnosis; D014786:Vision Disorders / Q000139:chemically induced / Q000175:diagnosis; D000077211:Zoledronic Acid
chemical_list: D050071:Bone Density Conservation Agents; D004164:Diphosphonates; D007093:Imidazoles; D000077211:Zoledronic Acid