Wu Zhaoquan, Sun Wei, Zhou Yulu, Wang Chunjiang
College of pharmacy, Changsha Medical University, Changsha, China.
Hunan Provincial Key Laboratory of the Research and Development of Novel Pharmaceutical Preparations, Changsha Medical University, Changsha, China.
Eye (Lond). 2025 Feb;39(3):538-543. doi: 10.1038/s41433-024-03586-0. Epub 2025 Jan 14.
Uveitis is a rare ocular adverse reaction of zoledronic acid, the specific clinical features are not clarified. This study was to investigate the clinical features of zoledronic acid-induced uveitis and provide reference for rational use of zoledronic acid.
We collected clinical data on zoledronic acid-induced uveitis for retrospective analysis by searching Chinese and English data up to October 31, 2024.
Uveitis occurred in 44 patients with a median age of 66.5 years (range 47, 87) and 93.2% in females. The median time to onset of uveitis was 48 h (range 10, 192). Eye pain (86.4%), decreased vision (61.4%), and redness (50.0%) were the most commonly described symptoms. Uveitis could involve unilateral eyes (68.2%) and bilateral eyes (31.8%), and anterior uveitis was the main type (95.5%). Most patients had intraocular pressure within the normal range. Slit lamp examination mainly revealed cells (54.5%), flare (43.2%), and keratic precipitates (29.5%). After discontinuation of zoledronic acid (97.6%) and receipt of topical steroids (97.7%), systemic steroids (15.9%), and cycloplegics (72.7%), all patients showed improvement or recovery.
Zoledronic acid-induced uveitis mainly occurs within 72 h after the initial administration, and anterior uveitis is predominant. When zoledronic acid is used, patients should be informed of possible adverse eye reactions. Topical corticosteroids can be used as the main treatment for uveitis.
葡萄膜炎是唑来膦酸罕见的眼部不良反应，其具体临床特征尚不明确。本研究旨在探讨唑来膦酸所致葡萄膜炎的临床特征，为唑来膦酸的合理使用提供参考。
通过检索截至2024年10月31日的中英文资料，收集唑来膦酸所致葡萄膜炎的临床资料进行回顾性分析。
44例患者发生葡萄膜炎，中位年龄66.5岁（范围4787岁），女性占93.2%。葡萄膜炎发病的中位时间为48小时（范围10192小时）。眼痛（86.4%）、视力下降（61.4%）和眼红（50.0%）是最常描述的症状。葡萄膜炎可累及单眼（68.2%）和双眼（31.8%），以前葡萄膜炎为主（95.5%）。大多数患者眼压在正常范围内。裂隙灯检查主要发现细胞（54.5%）、闪光（43.2%）和角膜后沉着物（29.5%）。停用唑来膦酸（97.6%）并接受局部类固醇治疗（97.7%）、全身类固醇治疗（15.9%）和睫状肌麻痹剂治疗（72.7%）后，所有患者均有改善或恢复。
唑来膦酸所致葡萄膜炎主要发生在首次给药后72小时内，以前葡萄膜炎为主。使用唑来膦酸时，应告知患者可能出现的眼部不良反应。局部糖皮质激素可作为葡萄膜炎的主要治疗药物。
