Fluoroquinolone use linked to retinal detachment risk

April 18, 2012

Patients taking oral fluoroquinolones had a higher risk of developing a retinal detachment compared with nonusers, although the absolute risk was small, according to a recent study.

Patients taking oral fluoroquinolones had a higher risk of developing a retinal detachment compared with nonusers, although the absolute risk was small, according to a recent study.

Most of the users of the antibiotics were taking them for urinary tract or respiratory infections, data showed.

"Despite numerous case reports of ocular toxicity, a pharmacoepidemiological study of their ocular safety, particularly retinal detachment, has not been performed," the authors wrote in JAMA (2012; 307:1414-19). "Retinal detachment is a serious medical emergency that may lead to irreversible vision loss."

First author Mahyar Etminan, PharmD, of the Child and Family Research Institute of British Columbia, Vancouver, and colleagues studied a group of patients in British Columbia who had visited an ophthalmologist between January 2000 and December 2007. Retinal detachment cases were defined as a procedure code for retinal repair surgery within 14 days of a physician service code. Ten controls were selected for each case.

The overall cohort included 989,591 patients; within this group, 4,384 cases of retinal detachment and 43,840 corresponding controls were identified for analysis. Cases were more likely to be male and were more likely to have myopia, diabetes, or have received cataract surgery. The authors found that retinal detachment was associated with a higher likelihood of current use of fluoroquinolones (3.3% of cases vs. 0.6% of controls).

For current users, the average number of days from the first fluoroquinolone prescription to the first event of a retinal detachment was 4.8 days. No risk was observed among recent users (0.3% of cases vs. 0.2% of controls) or past users (6.6% of cases vs. 6.1% of controls). The authors note that the absolute increase in the risk for this condition was small.

"This is the first study, to our knowledge, demonstrating that oral fluoroquinolones are associated with an increase in the risk of a retinal detachment. Current users of oral fluoroquinolones were nearly five times more likely to be diagnosed with retinal detachment than nonusers," the authors wrote, although because retinal detachment is rare among unexposed patients, the absolute risk increase is low.

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