An Investigation of The Association Between Retinal Detachment and Oral Fluoroquinolones: A Self-Controlled Case Series Study

Aim/Objective: To investigate the association between oral fl uoroquinolones (FQ) and retinal detachment (RD) and to estimate the absolute risk of developing RD in patients exposed to oral FQ. Methods: We performed a self-controlled case series study on Hong Kong, Taiwanese and British patients who had prescription(s) of oral FQ and RD procedure code(s) during 2001-2012; 2000-2010; and 1994-2012 respectively. Records were retrieved from the Hong Kong Clinical Data Analysis and Reporting System database, the Taiwan National Health Insurance Research Database and the United Kingdom IMS Disease Analyzer Database. Incidence rate ratios (IRR) are derived, by comparing the rate of RD during FQ exposed and non-exposed periods. Results: A total of 1,516,566 FQ prescriptions were prescribed to 836,249 patients. There were 455, 1002, 861 cases in Hong Kong, Taiwan and United Kingdom respectively. A total of 13 events were found during the FQ exposed period; and 2,305 during the non-exposed period. The adjusted IRR for patients in Hong Kong, Taiwan and United Kingdom were 1.16 (95%CI 0.36-3.75), 1.70 (0.84-3.46) and 0.65 (0.16-2.63) respectively. In the combined model, there was no statistically signifi cant association with an adjusted IRR of 1.27 (0.73-2.21). The crude absolute risk of RD whilst on oral FQ was approximately 1 per 150,000 prescriptions. Conclusion: Our study does not support the association between the use of FQ and RD. Therefore, the use of FQ should not be precluded based on the current evidence on the risk of RD. However, a further study is warranted to investigate this controversial association.