Increased Risk for Retinal Detachment With Fluoroquinolones

Richard T. Ellison III, MD


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In This Article

Abstract and Introduction


A retrospective pharmacoepidemiologic study suggests that such risk is increased by 4.5-fold in current fluoroquinolone users.


Although generally well tolerated, fluoroquinolones are known to have a destructive effect on connective tissue and have been associated with tendon rupture. Noting several reports of ocular injury linked to these antibiotics, investigators questioned whether such connective-tissue damage in the eye could predispose to retinal detachment. They explored this issue in a retrospective case-control analysis.

The researchers used records in the British Columbia Linked Health Database to identify patients who had visited an ophthalmologist in the province between 2000 and 2007. Patients who had experienced retinal detachment were each matched with 10 controls; all had 1 year of prescription drug data available. A total of 4384 patients and 43,840 controls were included in the analysis.

Risk for retinal detachment was significantly increased with current use of oral fluoroquinolones (adjusted relative risk, 4.5; 95% confidence interval, 3.6–5.7) but not with recent (prescription termination date, 1–7 days before the retinal-detachment index date) or past use. The mean time from fluoroquinolone prescription to retinal detachment was 4.8 days. No risk was seen with current use of oral β-lactam antibiotics or short-acting β-agonists, selected as pharmacologic controls. The absolute increase in risk for retinal detachment was 1 per 2500 person-years.