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Zoledronate is a newer bisphosphonate, primarily used for the treatment of tumour induced hypercalcaemia and skeletal related events in advanced bone malignancy. Bisphosphonates have been associated with a number of ocular side effects including conjunctivitis, episcleritis, scleritis, uveitis, and visual blurring.1 We report a case of acute retinal pigment epitheliitis following the use of intravenous zoledronate. To our knowledge bisphosphonates have not previously been associated with acute retinal pigment epitheliitis and could find no reference to it in computerised search utilising Medline and Pubmed.
A 47 year old glazier noted visual blurring and metamorphopsia within a day following intravenous infusion of zoledronate. One month after the infusion and onset of symptoms, his best corrected visual acuity was 6/5 in each eye. There was no vitritis or anterior uveitis. Fundus examination showed subtle clumps of hyperpigmentation surrounded by a paler halo of …