Original articleAdverse ocular drug reactions recently identified by the National Registry of Drug-Induced Ocular Side Effects☆
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
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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.