Elsevier

Ophthalmology

Volume 111, Issue 7, July 2004, Pages 1275-1279
Ophthalmology

Original article
Adverse ocular drug reactions recently identified by the National Registry of Drug-Induced Ocular Side Effects

Presented at: American Academy of Ophthalmology Annual Meeting, November 15–18, 2003; Anaheim, California.
https://doi.org/10.1016/j.ophtha.2003.12.052Get rights and content

Abstract

Purpose

To report recent ocular adverse drug reactions identified by the National Registry of Drug-Induced Ocular Side Effects.

Methods

Case reports from the National Registry and the World Health Organization were collected and adverse drug reactions categorized as follows: certain, probable/likely, possible, unlikely, and conditional/unclassifiable.

Results

Bisphosphonates are associated with ocular inflammation, including the first reports of drug-related scleritis. Topiramate is shown to cause angle-closure glaucoma. Cetirizine can cause an oculogyric crisis, and there is strong evidence retinoids cause intracranial hypertension.

Conclusion

Recent reports to the National Registry have led to identification of new ocular adverse drug reactions.

Section snippets

Materials and methods

Case reports from the National Registry of Drug-Induced Ocular Side Effects (Casey Eye Institute, Portland, Oregon), the Food and Drug Administration (Rockville, Maryland), the World Health Organization (WHO; Uppsala, Sweden), and the literature were reviewed to determine the relationship between the drug and the adverse ocular side effects. The WHO's Causality Assessment Guide was used to categorize adverse drug reactions (Table 1).

Bisphosphonates

Bisphosphonates are used to inhibit bone resorption in postmenopausal women, in the management of hypercalcemia of osteolytic bone cancer, and to treat metastases of breast cancer, multiple myeloma, and Paget's disease of the bone. Four hundred thirty-eight ocular side effects have been reported to the National Registry due to bisphosphonate therapy. The majority of adverse reactions are inflammatory (i.e., conjunctivitis, uveitis, and episcleritis), with symptoms of eye pain and photophobia

Discussion

In ophthalmology we rarely have scientific data as to the causation of an adverse ocular drug-related event. Unfortunately, much of our clinical ophthalmic toxicology relies on voluntary postmarketing surveillance systems and case reports. These, however, may provide information as to a temporal relationship, a pattern of presentation, dechallenge data, and, most importantly, rechallenge data.17, 18, 19 When analyzed with the WHO Causality Assessment Guide, these data may provide guidance for

References (19)

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Manuscript no. 230531.

This study was supported in part by an unrestricted grant from Research to Prevent Blindness, New York, New York.

The authors have no proprietary interest in these materials.

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