Pirbhai Adnan, Rajak Saul N, Goold Lucy A, Cunneen Thomas S, Wilcsek Geoff, Martin Peter, Leibovitch Igal, Selva Dinesh
a South Australian Institute of Ophthalmology, Royal Adelaide Hospital , Adelaide , South Australia .
b School of Ophthalmology and Visual Sciences , University of Adelaide , Adelaide , South Australia .
Orbit. 2015;34(6):331-5. doi: 10.3109/01676830.2015.1078380. Epub 2015 Nov 5.
To present a series of patients with bisphosphonate induced orbital inflammation, and to review the clinical presentation, radiological features, treatment options and outcomes.
We present a multicentre, retrospective case series review of patients with a clinico-radiological diagnosis of bisphosphonate induced orbital inflammation and review all the reported cases of this complication in the literature.
Four new patients with bisphosphonate induced orbital inflammation were added to the 25 cases in the literature. Intravenous zoledronate was the commonest precipitant (22/29, 75.9%) and inflammation occurred 1-28 (mean 3) days post-infusion. Orbital imaging identified orbital inflammation in 22/29 cases and extra-ocular muscle enlargement in 8/29. Five patients presented with reduced vision of which one - with anterior ischaemic optic neuropathy - did not resolve. The vision resolved in all except one patient, with most requiring steroid treatment.
Bisphosphonates have a pro-inflammatory effect, which can precipitate orbital inflammation. This rare, but potentially serious complication of bisphosphonate treatment should be considered by clinicians using bisphosphonate treatment and by ophthalmologists seeing patients with orbital inflammatory disease.
介绍一系列双膦酸盐诱导的眼眶炎症患者，并回顾其临床表现、影像学特征、治疗选择及预后。
我们对临床影像学诊断为双膦酸盐诱导眼眶炎症的患者进行了多中心回顾性病例系列研究，并复习了文献中所有报道的该并发症病例。
文献中25例双膦酸盐诱导眼眶炎症患者之外新增了4例。静脉注射唑来膦酸是最常见的诱发因素（22/29，75.9%），炎症发生于输注后1至28天（平均3天）。眼眶影像学检查在22/29例中发现眼眶炎症，8/29例出现眼外肌增粗。5例患者视力下降，其中1例伴前部缺血性视神经病变未恢复。除1例患者外，其余患者视力均恢复，多数患者需要类固醇治疗。
双膦酸盐具有促炎作用，可诱发眼眶炎症。使用双膦酸盐治疗的临床医生以及诊治眼眶炎性疾病患者的眼科医生应考虑到这种罕见但可能严重的双膦酸盐治疗并发症。
