Osteoporosis, bisphosphonates, and ocular inflammation

Area of Science:

• Ophthalmology
• Rheumatology
• Pharmacology

Background:

• Osteoporosis is a prevalent musculoskeletal disease in aging populations, characterized by reduced bone strength and increased fracture risk.
• Bisphosphonates are primary treatments for osteoporosis, effectively reducing fracture risk but posing challenges due to potential side effects.
• Ocular inflammation is a reported, vision-threatening side effect associated with bisphosphonate therapy.

Purpose of the Study:

• To conduct a comprehensive review of documented cases of ocular inflammation in patients undergoing bisphosphonate treatment.
• To synthesize existing literature on the ocular side effects linked to bisphosphonate medications.

Main Methods:

• A systematic literature survey was performed utilizing multiple databases.
• Data from published reports on bisphosphonate-associated ocular side effects were collected for a narrative review.

Main Results:

• Patients using bisphosphonates face a low but significant risk of ocular inflammation, with onset varying from hours to over three years post-exposure.
• Activated gamma delta T cells releasing inflammatory mediators are identified as the primary mechanism behind bisphosphonate-induced ocular inflammation.

Conclusions:

• Clinical management of osteoporosis must incorporate awareness of potential bisphosphonate-related ocular side effects.
• Ocular inflammation represents a serious, sight-threatening adverse event requiring prompt medical attention.
• Increased recognition of the bisphosphonate-ocular inflammation link can facilitate earlier diagnosis and effective treatment.