title: A systematic review and meta-analysis of the association between systemic fluoroquinolones and retinal detachment.
abstract: OBJECTIVE
  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 meta-analysis 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.
authors: Central Portugal Regional Pharmacovigilance Unit (UFC), Centre for Health Technology Assessment and Drug Research (CHAD), AIBILI - Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal.|School of Pharmacy, University of Coimbra, Coimbra, Portugal.
authors: Carlos
authors: C
authors: Alves
authors: Central Portugal Regional Pharmacovigilance Unit (UFC), Centre for Health Technology Assessment and Drug Research (CHAD), AIBILI - Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal.|School of Pharmacy, University of Coimbra, Coimbra, Portugal.
authors: Ana
authors: A
authors: Penedones
authors: Central Portugal Regional Pharmacovigilance Unit (UFC), Centre for Health Technology Assessment and Drug Research (CHAD), AIBILI - Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal.|School of Pharmacy, University of Coimbra, Coimbra, Portugal.
authors: Diogo
authors: D
authors: Mendes
authors: Central Portugal Regional Pharmacovigilance Unit (UFC), Centre for Health Technology Assessment and Drug Research (CHAD), AIBILI - Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal.|School of Pharmacy, University of Coimbra, Coimbra, Portugal.
authors: Francisco
authors: F
authors: Batel Marques
mesh_terms: D000900:Anti-Bacterial Agents / Q000009:adverse effects*; D016208:Databases, Factual; D024841:Fluoroquinolones / Q000009:adverse effects*; D006801:Humans; D012163:Retinal Detachment / Q000139:chemically induced*; D012307:Risk Factors
chemical_list: D000900:Anti-Bacterial Agents; D024841:Fluoroquinolones
keywords: drug safety; fluoroquinolones; meta-analysis; pharmacovigilance; post-marketing drug surveillance; retinal detachment