title: Oral fluoroquinolones and the risk of retinal detachment.
abstract: BACKGROUND
  Fluoroquinolones are commonly prescribed classes of antibiotics. Despite numerous case reports of ocular toxicity, a pharmacoepidemiological study of their ocular safety, particularly retinal detachment, has not been performed.
  
  
  OBJECTIVE
  To examine the association between use of oral fluoroquinolones and the risk of developing a retinal detachment.
  
  
  METHODS
  Nested case-control study of a cohort of patients in British Columbia, Canada, who had visited an ophthalmologist between January 2000 and December 2007. Retinal detachment cases were defined as a procedure code for retinal repair surgery within 14 days of a physician service code. Ten controls were selected for each case using risk-set sampling, matching on age and the month and year of cohort entry.
  
  
  METHODS
  The association between retinal detachment and current, recent, or past use of an oral fluoroquinolone.
  
  
  RESULTS
  From a cohort of 989,591 patients, 4384 cases of retinal detachment and 43,840 controls were identified. Current use of fluoroquinolones was associated with a higher risk of developing a retinal detachment (3.3% of cases vs 0.6% of controls; adjusted rate ratio [ARR], 4.50 [95% CI, 3.56-5.70]). Neither recent use (0.3% of cases vs 0.2% of controls; ARR, 0.92 [95% CI, 0.45-1.87]) nor past use (6.6% of cases vs 6.1% of controls; ARR, 1.03 [95% CI, 0.89-1.19]) was associated with a retinal detachment. The absolute increase in the risk of a retinal detachment was 4 per 10,000 person-years (number needed to harm = 2500 computed for any use of fluoroquinolones). There was no evidence of an association between development of a retinal detachment and β-lactam antibiotics (ARR, 0.74 [95% CI, 0.35-1.57]) or short-acting β-agonists (ARR, 0.95 [95% CI, 0.68-1.33]).
  
  
  CONCLUSIONS
  Patients taking oral fluoroquinolones were at a higher risk of developing a retinal detachment compared with nonusers, although the absolute risk for this condition was small.
authors.affiliation: Therapeutic Evaluation Unit, Child and Family Research Institute of British Columbia, Vancouver, Canada. metminan@popi.ubc.ca
authors.forename: Mahyar
authors.initials: M
authors.lastname: Etminan
authors.forename: Farzin
authors.initials: F
authors.lastname: Forooghian
authors.forename: James M
authors.initials: JM
authors.lastname: Brophy
authors.forename: Steven T
authors.initials: ST
authors.lastname: Bird
authors.forename: David
authors.initials: D
authors.lastname: Maberley
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000368:Aged; D001955:British Columbia / Q000453:epidemiology; D016022:Case-Control Studies; D005260:Female; D024841:Fluoroquinolones / Q000008:administration & dosage* / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012163:Retinal Detachment / Q000453:epidemiology*; D012189:Retrospective Studies; D012306:Risk
chemical_list: D024841:Fluoroquinolones