title: Association between recent use of fluoroquinolones and rhegmatogenous retinal detachment: a population-based cohort study.
abstract: BACKGROUND
  An association between use of oral fluoroquinolones (FQs) and retinal detachment remains controversial. This study was to determine the association of recent use of oral FQs and rhegmatogenous retinal detachment (RRD) after adjustment for confounding factors known to be associated with RRD.
  
  
  METHODS
  This retrospective population-based cohort study with parallel groups included adults treated with an oral FQ (FQ cohort = 178 179 prescriptions) and propensity score-matched adults treated with oral amoxicillin (amoxicillin cohort = 178 179 prescriptions). The data were extracted from the Taiwan National Health Insurance Research Database from 1998 to 2010. Interaction terms were used to identify populations at risk. RRD was defined according to the International Classification of Diseases, Ninth Revision, Clinical Modification.
  
  
  RESULTS
  During the 90-day follow-up period, 96 patients (0.054%) in the FQ cohort developed RRD compared to 46 (0.026%) among the matched amoxicillin cohort. The overall adjusted hazard ratio (HR) for FQ use and RRD was 2.07 (95% confidence interval [CI], 1.45-2.96). The interval between use of oral FQs and onset of RRD was 35.5 days (interquartile range, 14-57 days). Interaction terms were not significant for age, sex, diabetes, indications for antimicrobials, or underlying ophthalmic conditions. The adjusted HRs differed for specific FQs. These were 10.68 (95% CI, 3.28-34.82) for ciprofloxacin, 2.41 (95% CI, .76-7.68) for levofloxacin, 2.00 (95% CI, 1.06-3.79) for norfloxacin, and 1.17 (95% CI, .59-2.31) for ofloxacin.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Institute of Clinical Medicine, School of Medicine, National Yang-Ming University.
authors.forename: Shu-Chen
authors.initials: SC
authors.lastname: Kuo
authors.forename: Yung-Tai
authors.initials: YT
authors.lastname: Chen
authors.forename: Yi-Tzu
authors.initials: YT
authors.lastname: Lee
authors.forename: Nai-Wen
authors.initials: NW
authors.lastname: Fan
authors.forename: Shih-Jen
authors.initials: SJ
authors.lastname: Chen
authors.forename: Szu-Yuan
authors.initials: SY
authors.lastname: Li
authors.forename: Chia-Jen
authors.initials: CJ
authors.lastname: Liu
authors.forename: Te-Li
authors.initials: TL
authors.lastname: Chen
authors.forename: Tzeng-Ji
authors.initials: TJ
authors.lastname: Chen
authors.forename: Chang-Phone
authors.initials: CP
authors.lastname: Fung
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000009:adverse effects* / Q000627:therapeutic use*; D015331:Cohort Studies; D005260:Female; D024841:Fluoroquinolones / Q000009:adverse effects* / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012163:Retinal Detachment / Q000139:chemically induced* / Q000453:epidemiology*; D012189:Retrospective Studies; D013624:Taiwan
chemical_list: D000900:Anti-Bacterial Agents; D024841:Fluoroquinolones
keywords: fluoroquinolones; rhegmatogenous retinal detachment; risks