# Case report: A severe case of zoledronate-associated diffuse orbital inflammation and uveitis in a patient with metastatic breast cancer

## TL;DR

A patient with breast cancer developed eye inflammation after zoledronate treatment, highlighting a rare but serious side effect.

## Contribution

This case report adds to the understanding of zoledronate-induced ocular inflammation and emphasizes the need for prompt treatment.

## Key findings

- A 48-year-old woman developed anterior uveitis and orbital inflammation after zoledronate infusion.
- Treatment with corticosteroids led to complete resolution of inflammation within 2.5 weeks.
- Literature review confirms zoledronate-associated ocular inflammation is rare but sight-threatening if untreated.

## Abstract

Zoledronate is a commonly prescribed medication to maintain bone health; however, a rare side effect includes ocular inflammation. We report a case of simultaneous anterior uveitis and orbital inflammation associated with zoledronate infusion in a patient with metastatic breast cancer. We also performed a literature search to provide an up-to-date summary of cases with zoledronate-associated ocular inflammation.

This is a case report with literature review. Literature search (timeline 2010 to 2023) was performed using PubMed with the search team: (zoledronate) AND (uveitis OR scleritis OR orbital inflammation OR ocular inflammation).

A 48-year-old female presented with left eye pain, swelling, and decreased vision 2 days after receiving zoledronic acid infusion. An ophthalmic exam showed non-granulomatous anterior uveitis. CT orbits and ocular ultrasound showed signs of posterior scleritis and orbital inflammation. Ocular inflammation caused by an infection or metastatic cancer was ruled out. The patient was treated with both topical and systemic corticosteroids. Complete resolution of the inflammation occurred after 2.5 weeks.

Orbital inflammation and uveitis are an uncommon side effect of zoledronate but needs to be promptly recognized and treated to prevent sight-threatening complications.