Zoledronic Acid-Induced Orbital Inflammation: A Diagnostic Challenge

Area of Science:

• Ophthalmology
• Pharmacology
• Rheumatology

Background:

• Zoledronic acid is a bisphosphonate used for bone disorders.
• Rarely, it can cause ocular inflammation mimicking orbital cellulitis.

Purpose of the Study:

• To report a case of rapid-onset orbital inflammation secondary to zoledronic acid.
• To highlight the importance of recognizing this rare adverse effect.

Main Methods:

• Case report of a 52-year-old woman with new-onset eye pain and swelling post-zoledronic acid infusion.
• Clinical examination, laboratory tests, and imaging (CT, MRI) were performed.
• Treatment with corticosteroids and antibiotics.

Main Results:

• The patient presented with conjunctival redness and eyelid swelling within 24 hours of infusion.
• Imaging revealed preseptal and postseptal inflammation without abscess.
• Symptoms resolved completely within one week of treatment.

Conclusions:

• Zoledronic acid can induce rapid-onset orbital inflammation.
• Awareness is crucial for avoiding misdiagnosis and ensuring timely treatment.
• Early corticosteroid therapy is effective for this rare bisphosphonate ocular toxicity.