Association Between Recent Use of Fluoroquinolones and Rhegmatogenous Retinal Detachment: A Population-Based Cohort Study

Kuo, Shu‐Chen; Chen, Yung Tai; Lee, Yi-Tzu; Fan, Nai Wen; Chen, Shih‐Jen; Li, Szu Yuan; Liu, Chia Jen; Chen, Te Li; Chen, Tzeng Ji; Fung, Chang Phone

doi:10.1093/cid/cit708

Cited by 38 publications

(49 citation statements)

References 28 publications

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“…; Kuo et al. ). In both studies, fluoroquinolone users had a higher prevalence of comorbidities, such as renal and cardiovascular diseases.…”

Section: Resultsmentioning

confidence: 97%

“…; Kuo et al. ). While one study estimated an interval of 35.5 days between fluoroquinolones use and retinal detachment onset (Kuo et al.…”

Section: Discussionmentioning

confidence: 97%

“…While one study estimated an interval of 35.5 days between fluoroquinolones use and retinal detachment onset (Kuo et al. ), the other estimated a shorter period of 5 days (Etminan et al. ).…”

Section: Discussionmentioning

confidence: 99%

“…; Kuo et al. ). However, the results from other sources of evidence are contradictory with such findings (Pasternak et al.…”

Section: Introductionmentioning

confidence: 97%

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A systematic review and meta‐analysis of the association between systemic fluoroquinolones and retinal detachment

Alves

Penedones

Mendes

et al. 2016

Acta Ophthalmologica

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ABSTRACT.Purpose: Several pharmacoepidemiologic studies have been carried out evaluating the risk of retinal detachment associated with systemic fluoroquinolones. This meta-analysis aims to investigate such association, in the light of the best scientific evidence available. Methods: A literature search was conducted to identify relevant studies evaluating the risk for retinal detachment associated with systemic fluoroquinolones. A metaanalysis was performed to pool rate ratios (RRs). Meta-regressions were conducted aiming to evaluate the influence of time interval between fluoroquinolones use and retinal detachment diagnosis or treatment risk estimates. Results: Ten observational studies from seven publications were included. Overall, fluoroquinolones were not associated with an increased risk for retinal detachment [RR 1.47 (95% CI 0.95-2.27): p = 0.09; I 2 = 92.8%]. When the analysis was stratified according to different study designs, the result was statistically significant for retrospective cohort studies [RR 1.87 (95% CI 1.36-2.58); p < 0.001; I 2 = 0.0%] and for past users of fluoroquinolones, based on data from case-control studies [RR 1.07 (95% CI 1.01-1.12); p = 0.01; I 2 = 0.0%]. According to meta-regressions, the risk for retinal detachment did not vary due to different time intervals between fluoroquinolones prescription and retinal detachment occurrence. No statistically significant results were identified among studies evaluating only rhegmatogenous retinal detachments, as well as among studies that evaluated patients not requiring a prior ophthalmologist visit to be included. Conclusions:In light of the current available evidence, systemic fluoroquinolones do not seem to be associated with retinal detachment.

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“…; Kuo et al. ). In both studies, fluoroquinolone users had a higher prevalence of comorbidities, such as renal and cardiovascular diseases.…”

Section: Resultsmentioning

confidence: 97%

“…; Kuo et al. ). While one study estimated an interval of 35.5 days between fluoroquinolones use and retinal detachment onset (Kuo et al.…”

Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

“…; Kuo et al. ). However, the results from other sources of evidence are contradictory with such findings (Pasternak et al.…”

Section: Introductionmentioning

confidence: 97%

See 2 more Smart Citations

A systematic review and meta‐analysis of the association between systemic fluoroquinolones and retinal detachment

Alves

Penedones

Mendes

et al. 2016

Acta Ophthalmologica

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“…This is a potential concern because RDs are commonly repaired up to a week after the initial date of diagnosis and are not necessarily hospitalized that same day. Unlike other studies 2–5 that used a combination of outpatient diagnosis and surgical procedure codes to define the outcome, this ambiguity of diagnosis date allows for a possible surveillance bias. The decision for surgery, particularly when it is delayed for a day or more, often induces a pre-operative primary care exam on which concern for an unrelated infection could induce an antibiotic prescription to be written.…”

mentioning

confidence: 99%

Oral Fluoroquinolones, Retinal Detachments, and Claims Database Studies

VanderBeek

2016

JAMA Ophthalmol

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Risk of Aortic Dissection and Aortic Aneurysm in Patients Taking Oral Fluoroquinolone

et al. 2015

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IMPORTANCE Fluoroquinolones have been associated with collagen degradation, raising safety concerns related to more serious collagen disorders with use of these antibiotics, including aortic aneurysm and dissection. OBJECTIVE To examine the relationship between fluoroquinolone therapy and the risk of developing aortic aneurysm and dissection. DESIGN, SETTING, AND PARTICIPANTS We conducted a nested case-control analysis of 1477 case patients and 147 700 matched control cases from Taiwan's National Health Insurance Research Database (NHIRD) from among 1 million individuals longitudinally observed from January 2000 through December 2011. Cases patients were defined as those hospitalized for aortic aneurysm or dissection. One hundred control patients were matched for each case based on age and sex. EXPOSURES Current, past, or any prior-year use of fluoroquinolone. Current use was defined as a filled fluoroquinolone prescription within 60 days of the aortic aneurysm or dissection; past use refers to a filled fluoroquinolone prescription between 61 and 365 days prior to the aortic aneurysm; and any prior-year use refers to having a fluoroquinolone prescription filled for 3 or more days any time during the 1-year period before the aortic aneurysm or dissection. MAIN OUTCOMES AND MEASURES Risk of developing aortic aneurysm or dissection. RESULTS A total of 1477 individuals who experienced aortic aneurysm or dissection were matched to 147 700 controls. After propensity score adjustment, current use of fluoroquinolones was found to be associated with increased risk for aortic aneurysm or dissection (rate ratio [RR], 2.43; 95% CI, 1.83-3.22), as was past use, although this risk was attenuated (RR, 1.48; 95% CI, 1.18-1.86). Sensitivity analysis focusing on aortic aneurysm and dissection requiring surgery also demonstrated an increased risk associated with current fluoroquinolone use, but the increase was not statistically significant (propensity score-adjusted RR, 2.15; 95% CI, 0.97-4.60). CONCLUSIONS AND RELEVANCE Use of fluoroquinolones was associated with an increased risk of aortic aneurysm and dissection. While these were rare events, physicians should be aware of this possible drug safety risk associated with fluoroquinolone therapy.

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Association Between Recent Use of Fluoroquinolones and Rhegmatogenous Retinal Detachment: A Population-Based Cohort Study

Abstract: The use of oral FQs was associated with the subsequent occurrence of RRD. The FQ risk was independent of age, sex, diabetes, indications for antimicrobials, and underlying ophthalmic conditions. Certain FQs carried higher risk of RRD.

Cited by 38 publications

References 28 publications

A systematic review and meta‐analysis of the association between systemic fluoroquinolones and retinal detachment

A systematic review and meta‐analysis of the association between systemic fluoroquinolones and retinal detachment

Oral Fluoroquinolones, Retinal Detachments, and Claims Database Studies

Risk of Aortic Dissection and Aortic Aneurysm in Patients Taking Oral Fluoroquinolone

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