Zoledronic Acid Infusion and Orbital Inflammatory Disease

• Published in: The New England journal of medicine Vol. 359; no. 13; pp. 1410 - 1411
• Main Authors: Sharma, Neil S, Hooper, Michael J, Francis, Ian C, Masselos, Katherine, Ooi, Ju-Lee
• Format: Journal Article
• Language: English
• Published: United States Massachusetts Medical Society 25-09-2008
• Subjects: Bone Density Conservation Agents - adverse effects; Diphosphonates - adverse effects; Eye Diseases - chemically induced; Eye Diseases - diagnostic imaging; Humans; Imidazoles - adverse effects; Male; Middle Aged; Orbital Cellulitis - chemically induced; Radiography
• ISSN: 0028-4793; 1533-4406
• DOI: 10.1056/NEJMc0803366

A 57-year-old man presented with a 4-day history of increasing orbital pain and swelling in the right eye. A diagnosis of orbital inflammatory disease due to bisphosphonate infusion was made.
To the Editor:
Bisphosphonates are being used increasingly for the prevention and treatment of osteoporosis, hypercalcemia of malignant disease, and other disorders of bone metabolism. Known ocular complications of bisphosphonates include conjunctivitis, anterior uveitis, episcleritis, and scleritis.
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A 57-year-old man presented with a 4-day history of increasing orbital pain and swelling in the right eye. Three days before the onset of symptoms, he had received an infusion of zoledronic acid bisphosphonate for spontaneous osteonecrosis of the knee. His medical history was otherwise unremarkable.
On examination, his visual acuity was 20/60 in his right eye (corrected to 20/16 with the use . . .