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Oral antibiotic use may be linked to higher risk of retinal detachment
Patients taking oral fluoroquinolones may experience an increased risk of developing retinal detachment, a study found.
“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 … have not been reported,” the study authors wrote.
The case-control analysis included a cohort of 989,591 patients seen by an ophthalmologist between January 2000 and December 2007 in British Columbia, Canada. Retinal detachment was observed in 4,384 patients, identified by a procedure code for retinal repair surgery within 14 days of a physician service code. Using risk-set sampling, 10 controls were selected for each, totaling 43,840 patients.
An association between current fluoroquinolone use and higher risk was demonstrated, with 3.3% of patients with retinal detachment vs. 0.6% of control patients using fluoroquinolones. No association was observed for recent or past fluoroquinolone use; this suggests an acute adverse event, the study authors noted. Additionally, absolute increase in risk was only four per 10,000 person-years.
The exact mechanism of retinal detachment remains unknown; however, previously demonstrated damage to collagen and connective tissues by fluoroquinolones suggests the possibility of damage to other tissue, such as the that of the vitreous and vitreous cortex, according to the authors.
Study limitations included the inability to control for ocular trauma, to distinguish the type of retinal detachment, to assess risk in the general population and to examine the association for individual fluoroquinolones, the authors said. The study also lacked considerable information on patients’ prescription drug history.