Evidence map›Paper›PMID 41454062›Full record

ArticleEye (London, England)2026

Ocular adverse effects of bisphosphonates and association with osteonecrosis from a real-world database.

Samuel H Kim, Ehsan Rahimy, Euna B Koo, Chase A Ludwig, Andrea Lora Kossler, Prithvi Mruthyunjaya, Karen M Wai

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Eye (London, England), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

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5 · Who and what money

Authors and funding

7 authors.

Samuel H KimMedical Scientist Training Program, Stanford University School of Medicine, Palo Alto, CA, USA.ORCID 0000-0001-8353-6190
Ehsan RahimyByers Eye Institute, Stanford University School of Medicine, Palo Alto, CA, USA.ORCID 0000-0001-8446-7078
Euna B KooByers Eye Institute, Stanford University School of Medicine, Palo Alto, CA, USA.ORCID 0000-0003-4218-3338
Chase A LudwigByers Eye Institute, Stanford University School of Medicine, Palo Alto, CA, USA.
Andrea Lora KosslerByers Eye Institute, Stanford University School of Medicine, Palo Alto, CA, USA.
Prithvi MruthyunjayaByers Eye Institute, Stanford University School of Medicine, Palo Alto, CA, USA.
Karen M WaiByers Eye Institute, Stanford University School of Medicine, Palo Alto, CA, USA. kwai@stanford.edu.ORCID 0000-0001-8980-2242

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveWhile bisphosphonates are widely used to treat osteoporosis, ocular adverse effects (OAEs) and their associations with serious systemic side effects, such as osteonecrosis, remain unexplored in large, diverse cohorts.

methodRetrospective cohort study from a deidentified aggregated multinational electronic health records database. Patients were included based on no prior recorded history of OAEs, recorded prescription of bisphosphonates and a subsequent visit. The risk of osteonecrosis for patients with and without OAEs after bisphosphonate initiation was assessed. Propensity score matching was used to control for demographic factors and prior autoimmune conditions. Rates of OAEs were compared between patients on intravenous or oral bisphosphonates.

resultsA cohort of 944,559 patients was identified. The cohort mean age was 75 years. The most common OAEs were dry eyes (1.73%), cornea and ocular surface inflammation (0.97%), and uveitis (0.17%). Patients with any OAEs with bisphosphonate use compared to those without OAEs had an increased risk of osteonecrosis (RR: 1.48, (1.30, 1.93)), with the highest increased risk for zoledronate (RR: 2.22, (1.63-3.03)). Furthermore, intravenous bisphosphonates compared to oral bisphosphonates had an increased risk of dry eyes (RR: 1.27 (1.20, 1.36)) at all timepoints.

conclusionsAlthough rarer than reported in literature, our large cohort size revealed that patients on bisphosphonates with OAEs had an increased risk of osteonecrosis compared to those without OAEs. Patients on intravenous compared to oral bisphosphonates were at increased risk for OAEs. These findings guide ophthalmologists to identify OAEs from bisphosphonate use and to be vigilant for increased risks of systemic side effects.

Indexed as

Bone Density Conservation AgentsDiphosphonatesDry Eye SyndromesOsteonecrosisAgedAged, 80 and overDatabases, FactualElectronic Health RecordsFemaleHumansMaleMiddle AgedOsteoporosisPropensity ScoreRetrospective StudiesRisk FactorsBone Density Conservation AgentsDiphosphonates

Identifiers

PMID41454062
PMCPMC12957288

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.