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A Case Series and Review of Bisphosphonate-associated Orbital Inflammation |
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| Authors: | Daniel R. Lefebvre John T. Mandeville Yoshihiro Yonekawa Jorge G. Arroyo Nurhan Torun Suzanne K. Freitag |
| Affiliation: | 1. Ophthalmic Plastic Surgery Service, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA,;2. Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts, USA,;3. Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts, USA,;4. Eye Health Services, Inc., Quincy, Massachusetts, USA,;5. Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts, USA,;6. Beth Israel Deaconess Medical Center, Division of Ophthalmology, Boston, Massachusetts, USA |
| Abstract: | Purpose: 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. Conclusion: Clinicians should be aware of the association between acute orbital inflammation and recent treatment with systemic bisphosphonate medication. |
| Keywords: | Bisphosphonate idiopathic orbital inflammation orbital inflammation orbital pseudotumor zoledronate |