Romanian journal of ophthalmology · 2025
Ibandronic Acid Induced Orbital Inflammation and Concurrent Anterior Uveitis - A Rare Presentation.
СтатьяКлинический случайНазвание и аннотация: Перевод в очереди
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Periyandavan Jayasri, Purushothaman Amudha, Thanasekaran Vijhayapriya, Namaskaram Ezhilvathani T
Аннотация
AIM: To report the first case of orbital inflammation with concurrent anterior uveitis induced by oral Ibandronate, a bisphosphonate used for osteoporosis and other bone disorders.
MATERIAL AND METHODS: A 55-year-old female, with a history of diabetes and hypertension, developed bilateral eye pain, redness, and photophobia two days after taking oral Ibandronate for a thoracic spine fracture. Examination revealed reduced visual acuity, anterior uveitis at presentation, and bilateral proptosis two days later. The imaging revealed diffuse bilateral orbital inflammation.
RESULTS: After discontinuing the drug, the patient was treated with intravenous methylprednisolone, leading to significant improvement in ocular symptoms.
DISCUSSION: Bisphosphonates, including Ibandronate, can cause ocular adverse effects such as uveitis and orbital inflammation. The pathophysiology is linked to immune modulation via gamma T-cell activation. Most cases respond to discontinuation of drug and steroid administration. The risk-benefit ratio of steroid administration has to be weighed, as it can worsen osteoporosis. Early detection and timely discontinuation of the drug can avoid sight-threatening complications.
CONCLUSION: This case underscores the importance of early recognition and prompt management of ocular complications, particularly as the use of bisphosphonates continues to increase.
MATERIAL AND METHODS: A 55-year-old female, with a history of diabetes and hypertension, developed bilateral eye pain, redness, and photophobia two days after taking oral Ibandronate for a thoracic spine fracture. Examination revealed reduced visual acuity, anterior uveitis at presentation, and bilateral proptosis two days later. The imaging revealed diffuse bilateral orbital inflammation.
RESULTS: After discontinuing the drug, the patient was treated with intravenous methylprednisolone, leading to significant improvement in ocular symptoms.
DISCUSSION: Bisphosphonates, including Ibandronate, can cause ocular adverse effects such as uveitis and orbital inflammation. The pathophysiology is linked to immune modulation via gamma T-cell activation. Most cases respond to discontinuation of drug and steroid administration. The risk-benefit ratio of steroid administration has to be weighed, as it can worsen osteoporosis. Early detection and timely discontinuation of the drug can avoid sight-threatening complications.
CONCLUSION: This case underscores the importance of early recognition and prompt management of ocular complications, particularly as the use of bisphosphonates continues to increase.