Bisphosphonate-Associated Orbital Inflammatory Disease and Uveitis Anterior – a Case Report and Review

Background

Bisphosphonates are the most commonly used drugs to treat osteoporosis [1]. They are also used to treat other conditions featuring bone fragility such as osteitis deformans, bone metastasis, multiple myeloma, primary hyperparathyroidism and osteogenesis imperfecta. They inhibit the digestion of bone by encouraging osteoclasts to undergo apoptosis, thereby slowing bone loss.

Aminobisphosphonates are a newer generation of bisphosphonates that contain a nitrogen group. Pamidronate (Aredia®), alendronate (Fosamax®), ibandronate (Bonviva®), risedronate (Actonel®) and zoledronate (Zometa®, Aclasta®) are aminophosphates. It has been shown that these medications share several homologies with γδ T cell ligands, which can activate T cells and lead to a release of several cytokines [2].

Several ocular and orbital side effects have been reported following bisphosphonate application such as conjunctivitis, anterior uveitis, scleritis and orbital inflammation [3], [4], [5], [6], [7], [8]. We present a patient with bisphosphonate-induced unilateral orbital inflammation and bilateral anterior uveitis.

• References

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