Retinal detachment nearly five times more common in fluoroquinolone users
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Retinal detachment nearly five times more common in fluoroquinolone users Canadian researchers conclude that one of the most commonly prescribed classes of antibiotics is associated with an almost five-fold increase in the risk of retinal detachment. In a study funded by the Canadian National Institute for the Blind, researchers investigated a cohort of nearly one million patients who visited an ophthalmologist in British Columbia between January 2000 and December 2007. From this cohort, a total of 4384 cases of retinal detachment were identified and matched to 43 840 controls. Current fluoroquinolone use was associated with a significant increase in the risk of retinal detachment compared with non-use (adjusted risk ratio 4.50; 95% CI 3.56, 5.70). Recent use (within 7 days of diagnosis) and past use (8–365 days prior to diagnosis) were not associated with retinal detachment, nor was use of βlactam antibiotics or short-acting β-agonists (assessed as quality measures). The absolute risk associated with fluoroquinolone use was small; the number needed to harm, computed for any use of fluoroquinolones, was 2500. When cases were stratified by type of fluoroquinolone, ciprofloxacin contributed to the most cases of retinal detachment (82.7% of cases), followed by levofloxacin (7.2%) and norfloxacin (4.9%). Health Canada has only ever received one report of retinal detachment secondary to ciprofloxacin; however, the researchers suggest, cases may go unreported. "Because there are no previous studies associating oral fluoroquinolone use with retinal detachment, it is unlikely that treating retina surgeons suspected a possible link with oral fluoroquinolone use and retinal detachment, which may explain why more cases of retinal detachment secondary to fluoroquinolones have not been reported." Etminan M, et al. Oral Fluoroquinolones and the Risk of Retinal Detachment. JAMA: the Journal of the American Medical Association 307: 1414-1419, No. 13, 803069096 4 Apr 2012
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Reactions 14 Apr 2012 No. 1397
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