Association Between Oral Fluoroquinolone Use and Retinal Detachment

作者：Björn Pasternak, Henrik Svanström, Mads Melbye, Anders Peter Hviid · 发表于：JAMA · 年份：2013 · DOI：10.1001/jama.2013.280500 · 被引用次数：83 · 研究领域：Ocular Infections and Treatments、Retinal and Macular Surgery、Antibiotics Pharmacokinetics and Efficacy

IMPORTANCE: A recent study of ophthalmologic patients found a strong association between fluoroquinolone use and retinal detachment. Given the prevalent use of fluoroquinolones, this could, if confirmed in the general population, translate to many excess cases of retinal detachment that are potentially preventable. OBJECTIVE: To investigate if oral fluoroquinolone use is associated with an increased risk of retinal detachment. DESIGN, SETTING, AND PARTICIPANTS: A nationwide, register-based cohort study in Denmark from 1997 through 2011, using linked data on participant characteristics, filled prescriptions, and cases of retinal detachment with surgical treatment (scleral buckling, vitrectomy, or pneumatic retinopexy). The cohort included 748,792 episodes of fluoroquinolone use (660,572 [88%] ciprofloxacin) and 5,520,446 control episodes of nonuse. MAIN OUTCOMES AND MEASURES: Poisson regression was used to estimate rate ratios (RRs) for incident retinal detachment, adjusting for a propensity score that included a total of 21 variables. The risk windows were classified as current use (days 1-10 from start of treatment), recent use (days 11-30), past use (days 31-60), and distant use (days 61-180). RESULTS: A total of 566 cases of retinal detachment occurred, of which 465 (82%) were rhegmatogenous detachments; 72 in fluoroquinolone users and 494 in control nonusers. The crude incidence rate was 25.3 cases per 100,000 person-years in current users, 18.9 in recent users, 26.8 in p...