title: Use of anti-malarial drugs and the risk of developing eye disorders.
abstract: BACKGROUND
  Ocular toxicity was described in the late 1950s for some anti-malarial drugs, but only limited information is available on the comparison of ocular toxicity of different anti-malarials.
  
  
  METHODS
  We conducted a follow-up study with a nested case-control analysis using the General Practice Research Database to compare the risk of developing a first-time diagnosis of an eye disorder during exposure of mefloquine, chloroquine and/or proguanil or atovaquone/proguanil use to non-users. We calculated incidence rates with 95% confidence intervals (CI) and odds ratios using multivariate conditional logistic regression analyses.
  
  
  RESULTS
  We included 83,148 patients and identified 652 cases with an incident eye disorder. The incidence rates with 95% CI of all eye disorders combined in users of mefloquine, chloroquine and/or proguanil, atovaquone/proguanil or travellers not using anti-malarials were 5.3 (4.3-6.5), 7.1 (5.0-9.9), 6.3 (5.6-7.2) and 5.1 (4.6-5.7), per 1000 person-years, respectively. As compared to non-users of anti-malarials, the adjusted odds ratio with 95% CI in the nested case-control analysis for users of mefloquine, chloroquine and/or proguanil, or atovaquone/proguanil were 1.33 (1.01-1.75), 1.61 (1.06-2.45), and 1.25 (1.03-1.52), respectively.
  
  
  CONCLUSIONS
  The study provides evidence that there was an increased risk of eye disorders in users of all anti-malarials compared to non-users of anti-malarials.
authors.affiliation: Basel Pharmacoepidemiology Unit, Division of Clinical Pharmacy and Epidemiology, Department of Pharmaceutical Sciences, University Basel, Basel, Switzerland. Electronic address: schneiderc@uhbs.ch.
authors.forename: Cornelia
authors.initials: C
authors.lastname: Schneider
authors.affiliation: Safety Risk Management, F. Hoffmann-La Roche Ltd., Basel, Switzerland. Electronic address: miriam.adamcova@roche.com.
authors.forename: Miriam
authors.initials: M
authors.lastname: Adamcova
authors.affiliation: Boston Collaborative Drug Surveillance Program, Boston University School of Medicine, Lexington, MA, USA. Electronic address: sjick@bu.edu.
authors.forename: Susan S
authors.initials: SS
authors.lastname: Jick
authors.affiliation: University of Zuerich Centre for Travel Medicine, Institute for Social and Preventive Medicine, Zuerich, Switzerland. Electronic address: pat@ifspm.uzh.ch.
authors.forename: Patricia
authors.initials: P
authors.lastname: Schlagenhauf
authors.affiliation: Department of Epidemiology, Genentech Inc., South San Francisco, USA. Electronic address: miller.katie@gene.com.
authors.forename: Mary K
authors.initials: MK
authors.lastname: Miller
authors.affiliation: Safety Risk Management, F. Hoffmann-La Roche Ltd., Basel, Switzerland. Electronic address: hans-georg.rhein@roche.com.
authors.forename: Hans-Georg
authors.initials: HG
authors.lastname: Rhein
authors.affiliation: Basel Pharmacoepidemiology Unit, Division of Clinical Pharmacy and Epidemiology, Department of Pharmaceutical Sciences, University Basel, Basel, Switzerland; Boston Collaborative Drug Surveillance Program, Boston University School of Medicine, Lexington, MA, USA; Hospital Pharmacy, University Hospital Basel, Basel, Switzerland. Electronic address: meierch@uhbs.ch.
authors.forename: Christoph R
authors.initials: CR
authors.lastname: Meier
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000962:Antimalarials / Q000009:adverse effects* / Q000627:therapeutic use; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D005128:Eye Diseases / Q000139:chemically induced* / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D008288:Malaria / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D012306:Risk; D057236:Travel Medicine; D006113:United Kingdom / Q000453:epidemiology; D055815:Young Adult
chemical_list: D000962:Antimalarials
keywords: Atovaquone; Chloroquine; Mefloquine; Proguanil