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Bisphosphonates Related Ocular Side Effects: A Case Series and Review of Literature

Omer Gendelman 1 2Liana Tripto-Shkolnik 2 3Iris Vered 2 3Merav Lidar 1 2

Ocul Immunol Inflamm. 2021 May 20;1-5. doi: 10.1080/09273948.2021.1922705. .

Abstract

Objective: To describe the clinical features of patients with bisphosphonate related ocular side effects (BROSE).

Methods: The medical records of all patients with BROSE between January 2009 and December 2019 were reviewed.

Results: Nine cases with BROSE were identified. All subjects were female. Median age at diagnosis was of 69 years. The leading indication for bisphosphonate treatment was osteoporosis (n=7), Paget’s disease of bone (n=1) and breast cancer (n=1). Six (66.67%) patients presented with uveitis, one (11%) episcleritis and two (22%) with orbital inflammation. Five events (55.5%) occurred within 10 days of initiating the bisphosphonate and the rest (44.44%) developed within 2 weeks to 3 years later. Four (44.44%) patients had concurrent thyroid disease. An association was found between underlying thyroid disease or autoimmunity.

Conclusion: BROSE is an uncommon complication of bisphosphonate therapy occurring more frequently in patients with an autoimmune predisposition.