PDF(Pubmed)
Abstract：
The most frequently reported adverse reaction to zoledronic acid is an acute phase reaction resembling influenza. While rarer adverse events such as osteonecrosis of the jaw and atypical femoral fractures have gained significant recognition, the ocular adverse effects, particularly scleritis, are not yet fully comprehended. Here, we present the case of a 75-year-old female patient with osteoporosis who developed bilateral redness and intense eye pain 48 h after receiving a 5 mg intravenous dose of zoledronic acid. Clinical presentation suggested bilateral conjunctivitis, but treatment with levofloxacin eye drops and acyclovir ophthalmic gel exacerbated the symptoms over 2 days, predominantly affecting the left eye. Ocular ultrasonography revealed thickening of the left eyeball wall with a \"T\" sign, while an orbital CT scan showed increased thickness of the left sclera. Treatment with methylprednisolone 80 mg intravenous infusion twice daily led to gradual symptom improvement and eventual resolution of inflammation. This report, based on a review of relevant literature, investigates the treatment and outcomes of zoledronic acid-induced scleritis, emphasizing the importance for clinicians to promptly identify and manage this rare and serious ocular adverse reaction.
摘要：
最常报道的唑来膦酸不良反应是类似流感的急性期反应。虽然较罕见的不良事件，如颌骨坏死和不典型的股骨骨折已获得显著的认识，眼部不良反应，尤其是巩膜炎,还没有完全理解。这里,我们介绍一例75岁女性骨质疏松症患者,在接受5mg唑来膦酸静脉注射后48h出现双侧红肿和剧烈眼痛.临床表现提示双侧结膜炎，但治疗与左氧氟沙星滴眼液和阿昔洛韦眼用凝胶加剧了症状超过2天，主要影响左眼。眼部超声检查显示左侧眼球壁增厚，有“T”征，而眼眶CT扫描显示左侧巩膜厚度增加。每天两次静脉输注80mg甲基强的松龙治疗导致症状逐渐改善和最终炎症消退。这份报告,在回顾相关文献的基础上，研究唑来膦酸引起的巩膜炎的治疗和结果，强调临床医生及时识别和管理这种罕见和严重的眼部不良反应的重要性。
