title: A Case Series and Review of Bisphosphonate-associated Orbital Inflammation.
abstract: OBJECTIVE
  To report the largest series of new cases to date of bisphosphate-associated orbital inflammation.
  
  
  METHODS
  A retrospective case review of patients with orbital inflammation following treatment with systemic bisphosphonate.
  
  
  RESULTS
  Six patients over an 18-month period (2 males, 4 females) with an average age of 62.2 years had onset of orbital inflammatory symptoms 1-11 days after intravenous bisphosphonate infusion or, in 1 case, 4 weeks after initiation of oral bisphosphonate therapy. Imaging revealed diffuse orbital involvement in 3 cases, isolated lateral rectus muscle involvement in 2 cases, and superior rectus-levator involvement in 1 case. Two patients' symptoms resolved spontaneously within 2 weeks, and 3 responded rapidly and completely to corticosteroid therapy. The 1 patient on oral bisphosphonate had a slower but complete response to corticosteroid treatment.
  
  
  CONCLUSIONS
  Clinicians should be aware of the association between acute orbital inflammation and recent treatment with systemic bisphosphonate medication.
authors.affiliation: a Ophthalmic Plastic Surgery Service, Massachusetts Eye and Ear Infirmary , Boston , Massachusetts , USA .|b Department of Ophthalmology , Harvard Medical School , Boston , Massachusetts , USA .
authors.forename: Daniel R
authors.initials: DR
authors.lastname: Lefebvre
authors.affiliation: b Department of Ophthalmology , Harvard Medical School , Boston , Massachusetts , USA .|c Eye Health Services, Inc. , Quincy , Massachusetts , USA .
authors.forename: John T
authors.initials: JT
authors.lastname: Mandeville
authors.affiliation: b Department of Ophthalmology , Harvard Medical School , Boston , Massachusetts , USA .
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Yonekawa
authors.affiliation: b Department of Ophthalmology , Harvard Medical School , Boston , Massachusetts , USA .|d Beth Israel Deaconess Medical Center, Division of Ophthalmology , Boston , Massachusetts , USA.
authors.forename: Jorge G
authors.initials: JG
authors.lastname: Arroyo
authors.affiliation: b Department of Ophthalmology , Harvard Medical School , Boston , Massachusetts , USA .|d Beth Israel Deaconess Medical Center, Division of Ophthalmology , Boston , Massachusetts , USA.
authors.forename: Nurhan
authors.initials: N
authors.lastname: Torun
authors.affiliation: a Ophthalmic Plastic Surgery Service, Massachusetts Eye and Ear Infirmary , Boston , Massachusetts , USA .|b Department of Ophthalmology , Harvard Medical School , Boston , Massachusetts , USA .
authors.forename: Suzanne K
authors.initials: SK
authors.lastname: Freitag
mesh_terms: D000368:Aged; D019386:Alendronate / Q000009:adverse effects*; D050071:Bone Density Conservation Agents / Q000009:adverse effects*; D004164:Diphosphonates / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007093:Imidazoles / Q000009:adverse effects*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D054517:Orbital Cellulitis / Q000139:chemically induced* / Q000175:diagnosis / Q000503:physiopathology; D016727:Orbital Pseudotumor / Q000139:chemically induced* / Q000175:diagnosis / Q000503:physiopathology; D012075:Remission, Spontaneous; D012189:Retrospective Studies; D000077211:Zoledronic Acid
chemical_list: D050071:Bone Density Conservation Agents; D004164:Diphosphonates; D007093:Imidazoles; D000077211:Zoledronic Acid; D019386:Alendronate
keywords: Bisphosphonate; idiopathic orbital inflammation; orbital inflammation; orbital pseudotumor; zoledronate