Drug-Induced Uveitis
Drug-Induced Uveitis
Bisphosphonates, such as etidronate, pamidronate, alendronate, risedronate, and zoledronate, are analogs of pyrophosphate that retard the formation and dissolution of hydroxyapatite crystals in skeletal and nonskeletal tissues. They inhibit bone resorption and are indicated for the treatment of osteoporosis. In a literature review reported by Rey et al, 18 patients developed ocular side effects within 24 to 48 hours of initiation of an infusion of bisphosphonate. The most common manifestation was anterior uveitis and the majority of the cases had bilateral involvement. Discontinuation of the bisphosphonate and initiation of steroid therapy resulted in a favorable outcome. Anterior uveitis has been reported after the administration of pamidronate, alendronate, risedronate, and zoledronate. Fraunfelder and Fraunfelder reviewed data from the spontaneous reporting systems of the National Registry of Drug-Induced Ocular Side Effects, the Food and Drug Administration, and the World Health Organization and reported that there were 66 cases of uveitis associated with pamidronate and 19 cases of uveitis associated with alendronate. In addition to being implicated in the development of uveitis, some bisphosphonates have been associated with scleritis or orbital inflammation.
Bisphosphonates
Bisphosphonates, such as etidronate, pamidronate, alendronate, risedronate, and zoledronate, are analogs of pyrophosphate that retard the formation and dissolution of hydroxyapatite crystals in skeletal and nonskeletal tissues. They inhibit bone resorption and are indicated for the treatment of osteoporosis. In a literature review reported by Rey et al, 18 patients developed ocular side effects within 24 to 48 hours of initiation of an infusion of bisphosphonate. The most common manifestation was anterior uveitis and the majority of the cases had bilateral involvement. Discontinuation of the bisphosphonate and initiation of steroid therapy resulted in a favorable outcome. Anterior uveitis has been reported after the administration of pamidronate, alendronate, risedronate, and zoledronate. Fraunfelder and Fraunfelder reviewed data from the spontaneous reporting systems of the National Registry of Drug-Induced Ocular Side Effects, the Food and Drug Administration, and the World Health Organization and reported that there were 66 cases of uveitis associated with pamidronate and 19 cases of uveitis associated with alendronate. In addition to being implicated in the development of uveitis, some bisphosphonates have been associated with scleritis or orbital inflammation.
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