Severe unilateral hypopyon uveitis secondary to Zoledronate infusion masquerading as endophthalmitis
Zoledronate-associated hypopyon uveitis
DOI:
https://doi.org/10.62856/djcro.v10.69Abstract
Zoledronate is a bisphosphonate medication used to treat osteoporosis and metastatic bone disease. We report an 81-year-old female who developed severe unilateral hypopyon-associated anterior and intermediate uveitis after her first intravenous zoledronate infusion for osteoporosis, initially concerning for endogenous endophthalmitis. Her visual acuity (VA) at presentation was hand motion (HM). Given the abrupt symptom onset and the initial severity of her presentation, there was concern for endogenous endophthalmitis. The patient underwent a vitreous tap, intravitreal antibiotics, and an unrevealing systemic work-up. Treatment comprised frequent topical corticosteroids, high-dose oral corticosteroids, and zoledronate cessation. Her intraocular inflammation resolved completely, although she later developed macular edema. At 3-month follow-up, VA improved to 20/70. Ocular inflammation following bisphosphonate use is rare and can have variable presentation. Our case underscores the importance of detailed medication history and considering drug-induced uveitis in acute intraocular inflammation. Prompt recognition and appropriate treatment can result in favorable visual outcomes.
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