Cargando…

Alendronate induced chorioretinitis: The importance of meticulous assessments

PURPOSE: To report a case of presumed bilateral chorioretinitis secondary to alendronate therapy. OBSERVATIONS: A 71-year-old female presented to the clinic in July 2017 with six months history of difficulty in reading along with floaters in both eyes which were more severe in the right eye. Past me...

Descripción completa

Detalles Bibliográficos
Autores principales: Hassan, Muhammad, Maleki, Arash, Ying, Qian, Nguyen, Nam, Halim, Muhammad Sohail, Sepah, Yasir J., Do, Diana V., Nguyen, Quan Dong
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6374782/
https://www.ncbi.nlm.nih.gov/pubmed/30809598
http://dx.doi.org/10.1016/j.ajoc.2019.01.007
_version_ 1783395233522778112
author Hassan, Muhammad
Maleki, Arash
Ying, Qian
Nguyen, Nam
Halim, Muhammad Sohail
Sepah, Yasir J.
Do, Diana V.
Nguyen, Quan Dong
author_facet Hassan, Muhammad
Maleki, Arash
Ying, Qian
Nguyen, Nam
Halim, Muhammad Sohail
Sepah, Yasir J.
Do, Diana V.
Nguyen, Quan Dong
author_sort Hassan, Muhammad
collection PubMed
description PURPOSE: To report a case of presumed bilateral chorioretinitis secondary to alendronate therapy. OBSERVATIONS: A 71-year-old female presented to the clinic in July 2017 with six months history of difficulty in reading along with floaters in both eyes which were more severe in the right eye. Past medical and surgical history revealed a history of hypertension, gout, hyperthyroidism, osteoporosis, and humerus fracture. She was started on alendronate three months before developing ocular symptoms. On ocular examination, best corrected visual acuity was 20/30 in the right and 20/25 in the left eye. Slit-lamp examination demonstrated normal anterior chamber examination in both eyes. Dilated fundus examination revealed geographic chorioretinal lesions around the optic nerve head in both eyes, more extensively in the right eye; and superior and temporal to the macula in the right eye. Past ocular records in February 2015 did not reveal any such findings. Fundus autofluorescence demonstrated hyper-autofluorescence in the peripapillary lesions in both eyes. The lesion adjacent to the macula in right eye displayed mixed hyper and hypo-autofluorescence. Fluorescein angiography showed combined hyper- and hypo-fluorescence compatible with window defect, staining and blockage. However, no leakage was appreciated in the macula, peripapillary, and peripheral lesions in both eyes. Optical coherence tomography scan showed septate hyporeflective intraretinal spaces in the right eye. CONCLUSION AND IMPORTANCE: The index report underscore the importance of considering alendronate as an etiologic cause of chorioretinitis, especially in subjects with atypical lesions developing after alendronate therapy. We, therefore, recommend discontinuation of this medication in subjects who develop chorioretinitis after employing this medication.
format Online
Article
Text
id pubmed-6374782
institution National Center for Biotechnology Information
language English
publishDate 2019
publisher Elsevier
record_format MEDLINE/PubMed
spelling pubmed-63747822019-02-26 Alendronate induced chorioretinitis: The importance of meticulous assessments Hassan, Muhammad Maleki, Arash Ying, Qian Nguyen, Nam Halim, Muhammad Sohail Sepah, Yasir J. Do, Diana V. Nguyen, Quan Dong Am J Ophthalmol Case Rep Case Report PURPOSE: To report a case of presumed bilateral chorioretinitis secondary to alendronate therapy. OBSERVATIONS: A 71-year-old female presented to the clinic in July 2017 with six months history of difficulty in reading along with floaters in both eyes which were more severe in the right eye. Past medical and surgical history revealed a history of hypertension, gout, hyperthyroidism, osteoporosis, and humerus fracture. She was started on alendronate three months before developing ocular symptoms. On ocular examination, best corrected visual acuity was 20/30 in the right and 20/25 in the left eye. Slit-lamp examination demonstrated normal anterior chamber examination in both eyes. Dilated fundus examination revealed geographic chorioretinal lesions around the optic nerve head in both eyes, more extensively in the right eye; and superior and temporal to the macula in the right eye. Past ocular records in February 2015 did not reveal any such findings. Fundus autofluorescence demonstrated hyper-autofluorescence in the peripapillary lesions in both eyes. The lesion adjacent to the macula in right eye displayed mixed hyper and hypo-autofluorescence. Fluorescein angiography showed combined hyper- and hypo-fluorescence compatible with window defect, staining and blockage. However, no leakage was appreciated in the macula, peripapillary, and peripheral lesions in both eyes. Optical coherence tomography scan showed septate hyporeflective intraretinal spaces in the right eye. CONCLUSION AND IMPORTANCE: The index report underscore the importance of considering alendronate as an etiologic cause of chorioretinitis, especially in subjects with atypical lesions developing after alendronate therapy. We, therefore, recommend discontinuation of this medication in subjects who develop chorioretinitis after employing this medication. Elsevier 2019-01-09 /pmc/articles/PMC6374782/ /pubmed/30809598 http://dx.doi.org/10.1016/j.ajoc.2019.01.007 Text en © 2019 Published by Elsevier Inc. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Case Report
Hassan, Muhammad
Maleki, Arash
Ying, Qian
Nguyen, Nam
Halim, Muhammad Sohail
Sepah, Yasir J.
Do, Diana V.
Nguyen, Quan Dong
Alendronate induced chorioretinitis: The importance of meticulous assessments
title Alendronate induced chorioretinitis: The importance of meticulous assessments
title_full Alendronate induced chorioretinitis: The importance of meticulous assessments
title_fullStr Alendronate induced chorioretinitis: The importance of meticulous assessments
title_full_unstemmed Alendronate induced chorioretinitis: The importance of meticulous assessments
title_short Alendronate induced chorioretinitis: The importance of meticulous assessments
title_sort alendronate induced chorioretinitis: the importance of meticulous assessments
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6374782/
https://www.ncbi.nlm.nih.gov/pubmed/30809598
http://dx.doi.org/10.1016/j.ajoc.2019.01.007
work_keys_str_mv AT hassanmuhammad alendronateinducedchorioretinitistheimportanceofmeticulousassessments
AT malekiarash alendronateinducedchorioretinitistheimportanceofmeticulousassessments
AT yingqian alendronateinducedchorioretinitistheimportanceofmeticulousassessments
AT nguyennam alendronateinducedchorioretinitistheimportanceofmeticulousassessments
AT halimmuhammadsohail alendronateinducedchorioretinitistheimportanceofmeticulousassessments
AT sepahyasirj alendronateinducedchorioretinitistheimportanceofmeticulousassessments
AT dodianav alendronateinducedchorioretinitistheimportanceofmeticulousassessments
AT nguyenquandong alendronateinducedchorioretinitistheimportanceofmeticulousassessments