Bisphosphonate-Induced Bilateral Anterior Uveitis and Choroidal Effusions With Secondary Angle Closure

Thng, Zheng Xian; Li, Zhenghao Kelvin; Gan, Nicola Y.

doi:10.1097/icb.0000000000000850

Cited by 4 publications

(3 citation statements)

References 10 publications

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“…The most recent case report of bisphosphonate-associated AAC described a patient who developed bilateral anterior uveitis and secondary angle closure within seven weeks of initiating her weekly oral alendronate for management of her scleroderma and antiphospholipid syndrome. (10) Similarly, an earlier case report described a patient who also developed severe anterior uveitis with secondary increase in intraocular pressure within 48 hours of starting her zoledronate infusion for osteoporosis. (9) In that case, the patient required topical steroids to treat her uveitis in the background of known glaucoma and steroid response.…”

Section: Discussionmentioning

confidence: 92%

“…(8) Over the last decade, there have been reports of the literature suggesting an association between bisphosphonate use and glaucoma. (9,10) In the absence of well-designed large epidemiologic studies, it is di cult to ascertain whether there exists a potential relationship between BP use and glaucoma. Moreover, to our knowledge, no epidemiologic study to date has quanti ed the risk between BPs and glaucoma.…”

Section: Introductionmentioning

confidence: 99%

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Risk of glaucoma with bisphosphonate use in patients with osteoporosis

He,

Etminan,

Darwich

et al. 2023

Preprint

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Purpose Bisphosphonates (BPs) are first line agents commonly used in the management of osteoporosis. There have been two case reports that have suggested a possible link between BPs and acute angle closure (AAC). In the absence of any large epidemiologic studies, we sought to determine the risk of AAC and OAG with bisphosphonate use in patients with osteoporosis.Methods This was a retrospective cohort study with a case control analysis from 2008–2018. The study used the PharMetrics Plus Database (IQVIA, USA) which captures health claims for over 150 million unique patients, with fully adjudicated pharmacy and medical claims, and represents all geographic areas of the United States. 208,111 patients with osteoporosis were included in the study. AAC and OAG cases were defined by an ICD-9/10 code and had to have at least one prescription for bisphosphonate every 3 months in the year prior to the index date. The date of the first event of AAC was designated as the index date.Results Bisphosphonate users were more likely to develop AAC than non-users (adjusted IRR = 1.78, 95%CI [1.05–3.01]). In particular, those on risedronate were more likely to develop AAC compared to patients who used other formulations of bisphosphonates (adjusted IRRs = 2.12, 95%CI [1.05–3.01]). There was no risk for OAG with bisphosphonate use.Conclusions Patients with osteoporosis who used BPs were at a higher risk for AAC compared to those who did not, and those who were on risedronate were more likely to develop AAC compared to patients who used other types of bisphosphonates.

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Section: Discussionmentioning

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Risk of glaucoma with bisphosphonate use in patients with osteoporosis

He,

Etminan,

Darwich

et al. 2023

Preprint

View full text Add to dashboard Cite

show abstract

“…Recent analyses and case reports have also linked Zonisamide, a sulfonamide-derivative antiseizure medication and Brolucizumab, a humanized single-chain antibody fragment that inhibits all the isoforms of VEGF-A, to choroidal effusions with or without acute angle closure [47][48][49]. Bisphosphonate usage has been suggested as a possible cause of bilateral anterior uveitis and choroidal effusions [50]. Medicationinduced effusions typically resolve with discontinuation of the offending agent and the use of topical steroids and cycloplegic agents.…”

Section: Medicationsmentioning

confidence: 99%

Risk factors and management of choroidal effusions

Ying

Sidoti

Panarelli

2022

Current Opinion in Ophthalmology

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Purpose of reviewChoroidal effusions are recognized as a common early postoperative complication of glaucoma surgery, and although often benign, they may cause significant ocular morbidity. This article aims to summarize current research on the risk factors and management of choroidal effusions.Recent findingsGlaucoma drainage device (GDD) implantation and trabeculectomy are the most commonly performed surgeries for the management of moderate to severe glaucoma. Common postoperative complications of these procedures include hypotony and the development of choroidal effusions. Choroidal effusions have recently been associated with the oral administration of certain drugs, including select monoclonal antibody, antiseizure and bisphosphonate medications. Risk factors for effusion development include specific patient characteristics such as pseudoexfoliative glaucoma, older age and hypertension. Although choroidal effusions typically resolve with medical therapy alone, surgical intervention may be required. Various methods of surgical intervention, such as surgical drainage or GDD tube ligation, can be utilized to treat choroidal effusions when conservative management with medical treatment fails, but themselves carry alternative risks that must be considered.SummaryMinimizing the incidence and duration of hypotony following ophthalmic surgery and careful monitoring of patients starting certain oral medications are important in limiting the occurrence of choroidal effusions. Risk factors for choroidal effusions have been recently identified in the literature. A better understanding of these risk factors, as well as the outcomes of choroidal effusion management, can help to reduce the occurrence of effusions overall and minimize ocular morbidity.

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Alendronic-acid

2021

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Bisphosphonate-Induced Bilateral Anterior Uveitis and Choroidal Effusions With Secondary Angle Closure

Cited by 4 publications

References 10 publications

Risk of glaucoma with bisphosphonate use in patients with osteoporosis

Risk of glaucoma with bisphosphonate use in patients with osteoporosis

Risk factors and management of choroidal effusions

Alendronic-acid

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