The risk profile of rhegmatogenous retinal detachment before and after using a fluoroquinolone: a 12 year nationwide self-controlled case series study

J Antimicrob Chemother. 2018 Dec 1;73(12):3442-3453. doi: 10.1093/jac/dky336.

Abstract

Objectives: To determine whether or not fluoroquinolone use increases the incidence of retinal detachment.

Design: Self-controlled case series analysis.

Participants: Participants were identified using the South Korean National Health Insurance Database between 1 January 2004 and 31 December 2015. A total of 15 134 patients who experienced rhegmatogenous retinal detachment (RRD) with at least one prescription of a fluoroquinolone were included.

Methods: Incidence rate ratios (IRRs) and their 95% CIs were calculated using conditional Poisson regression. The main outcome measure was a recorded diagnosis of RRD (ICD-10: H33.0) with a claim for the surgical code for RRD.

Results: We found an increased risk of retinal detachment in the first 1-30 days following the initiation of fluoroquinolone therapy (IRR 1.85; 95% CI 1.71-1.95), which rose for the 31-60 days period (IRR 2.05; 95% CI 1.43-2.95) but remained constant after more than 60 days (IRR 1.25; 95% CI 0.75-2.10). However, the elevated risk was also found in the 1-30 day period prior to the initiation of fluoroquinolone therapy (IRR 1.58; 95% CI 1.49-1.68) and also 31-60 days before medication use (IRR 1.11; 95% CI 1.03-1.19).

Conclusions: Our case-based study indicated that the risk after fluoroquinolone exposure doubled; however, the risk profile before and after fluoroquinolone use means that the association between fluoroquinolone use and retinal detachment might not be a causal relationship.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Anti-Bacterial Agents / administration & dosage*
  • Anti-Bacterial Agents / adverse effects*
  • Female
  • Fluoroquinolones / administration & dosage*
  • Fluoroquinolones / adverse effects*
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Republic of Korea / epidemiology
  • Retinal Detachment / chemically induced*
  • Retinal Detachment / epidemiology*
  • Risk Assessment

Substances

  • Anti-Bacterial Agents
  • Fluoroquinolones