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A Case Series and Review of Bisphosphonate-associated Orbital Inflammation
Daniel R Lefebvre1,2, John T Mandeville2,3, Yoshihiro Yonekawa2
1a Ophthalmic Plastic Surgery Service, Massachusetts Eye and Ear Infirmary , Boston , Massachusetts , USA .
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.
