A Case Series and Review of Bisphosphonate-associated Orbital Inflammation

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.

• Bisphosphonate
• idiopathic orbital inflammation
• orbital inflammation
• orbital pseudotumor
• zoledronate

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.

This paper was presented at the Spring meeting of the American Society of Ophthalmic Plastic and Reconstructive Surgery (ASOPRS), June 9, 2013, Newport, RI.