Abstract
To report two cases of bisphosphonate-induced orbital inflammation, discuss the clinic-radiological features and management options, and highlight the increasing frequency of an association previously considered extremely rare. A retrospective review of two cases presenting to our department, and review of the literature reporting this association. Two new cases of bisphosphonate-induced orbital inflammation were added to the literature. The first occurred in the context of a risedronate re-challenge, and the second with zoledronic acid. Both cases were managed successfully with topical steroids. Clinicians prescribing bisphosphonates, particularly for the first time, should be aware of the increasingly reported association with orbital inflammation. The presence of suggestive clinical features should prompt urgent referral to an ophthalmologist for appropriate management.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
NICE (2017) TA464: bisphosphonates for treating osteoporosis. National Institute for Health and Care Excellence, London
Mbekeani JN, Slamovits TL, Schwartz BH, Sauer HL (1999) Ocular inflammation associated with alendronate therapy. Arch Ophthalmol 117(6):837–838
Umunakwe OC, Herren D, Kim SJ, Kohanim S (2017) Diffuse ocular and orbital inflammation after zoledronate infusion-case report and review of the literature. Digit J Ophthalmol 23(4):18–21
Lefebvre DR, Mandeville JT, Yonekawa Y, Arroyo JG, Torun N, Case Series FSKA (2016) Review of bisphosphonate-associated orbital inflammation. Ocul Immunol Inflamm 24(2):134–139
Pirbhai A, Rajak SN, Goold LA, Cunneen TS, Wilcsek G, Martin P et al (2015) Bisphosphonate-induced orbital inflammation: a case series and review. Orbit (Amsterdam, Netherlands) 34(6):331–335
Ryan PJ, Sampath R (2001) Idiopathic orbital inflammation following intravenous pamidronate. Rheumatology (Oxford, England) 40(8):956–957
Subramanian PS, Kerrison JB, Calvert PC, Miller NR (2003) Orbital inflammatory disease after pamidronate treatment for metastatic prostate cancer. Arch Ophthalmol 121(9):1335–1336
Phillips PM, Newman SA (2008) Orbital inflammatory disease after intravenous infusion of zoledronate for treatment of metastatic renal cell carcinoma. Arch Ophthalmol (Chicago, Ill : 1960) 126(1):137–139
Sharma NS, Ooi JL, Masselos K, Hooper MJ, Francis IC (2008) Zoledronic acid infusion and orbital inflammatory disease. N Engl J Med 359(13):1410–1411
Seth A, Anderson DP, Albiani DA, Barton JJ (2009) Orbital inflammation and optic neuropathy with zoledronic acid for metastatic prostate cancer. Can J Ophthalmol 44(4):467–468
Missotten G, Verheezen Y (2010) Orbital inflammation after use of zoledronic acid for metastasized prostate carcinoma. Bull Soc Belge Ophtalmol 315:23–24
Procianoy F, Procianoy E (2010) Orbital inflammatory disease secondary to a single-dose administration of zoledronic acid for treatment of postmenopausal osteoporosis. Osteoporos Int 21(6):1057–1058
Yang EB, Birkholz ES, Lee AG (2010) Another case of bisphosphonate-induced orbital inflammation. J Neuroophthalmol 30(1):94–95
Yeo J, Jafer AK (2010) Zolendronate associated inflammatory orbital disease. N Z Med J 123(1323):50–52
Kaur H, Uy C, Kelly J, Moses AM (2011) Orbital inflammatory disease in a patient treated with zoledronate. Endocr Pract 17(4):e101–e103
Ortiz-Perez S, Fernandez E, Molina JJ, Sanchez-Dalmau B, Navarro M, Corretger X et al (2011) Two cases of drug-induced orbital inflammatory disease. Orbit (Amsterdam, Netherlands) 30(1):37–39
Schwab P, Harmon D, Bruno R, Fraunfelder FW, Hyunchung Kim D (2012) A 55-year-old woman with orbital inflammation. Arthritis Care Res 64(11):1776–1782
Boni C, Kordic H, Chaloupka K (2013) Bisphosphonate-associated orbital inflammatory disease and uveitis anterior--a case report and review. Klin Monbl Augenheilkd 230(4):367–369
Peterson JD, Bedrossian EH Jr (2012) Bisphosphonate-associated orbital inflammation--a case report and review. Orbit (Amsterdam, Netherlands) 31(2):119–123
Vora MM, Rodgers IR, Uretsky S (2014) Nitrogen bisphosphonate-induced orbital inflammatory disease: gamma delta T cells--a report and review of 2 cases. Ophthalmic Plast Reconstr Surg 30(4):e84–e85
Kunzmann V, Bauer E, Feurle J, Weissinger F, Tony HP, Wilhelm M (2000) Stimulation of gammadelta T cells by aminobisphosphonates and induction of antiplasma cell activity in multiple myeloma. Blood 96(2):384–392
Mbekeani JN, Slamovits TL, Schwartz BH, Sauer HL (1999) Ocular inflammation associated with alendronate therapy. Arch Ophthalmol 117(6):837–838
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
None.
Declaration
The content of this submission has not been published or submitted for publication elsewhere.
Declaration of Helsinki
The report adhered to the ethical principles outlined in the 2013 amended Declaration of Helsinki.
Additional information
Publisher’s Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Chehade, L., Curragh, D. & Selva, D. Bisphosphonate-induced orbital inflammation: more common than once thought?. Osteoporos Int 30, 1117–1120 (2019). https://doi.org/10.1007/s00198-019-04850-w
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00198-019-04850-w