Antibiotics not linked to retinal detachment

The use of a class of antibiotics known as fluoroquinolones may not increase the risk of retinal detachment, according to a study released Tuesday that contradicts previous research. Retinal detachment, a separation of the retina from its connection at the back of the eye, is an acute eye disorder that may lead to loss of vision despite prompt surgical intervention. In 2012, Canadian researchers concluded that use of fluoroquinolones was strongly associated with retinal detachment. In the new study published in the Journal of the American Medical Association, Bjorn Pasternak of the Statens Serum Institut, Denmark, and colleagues used data from a nationwide register to investigate this association. The register had information of nearly 750,000 episodes of fluoroquinolone use and more than 5.5 million control episodes of nonuse between 1997 and 2011, including data on participant characteristics, drugs used, and cases of retinal detachment with surgical treatment. They found 566 retinal detachment cases, including 72 in fluoroquinolone users and 494 in nonusers. Most had taken ciprofloxacin while others had used ofloxacin, fleroxacine or moxifloxacin. "In contrast to a recent nested case-control study from Canada, this nationwide, population-based cohort study in Denmark found no significant association between fluoroquinolone use and retinal detachment," the researchers wrote in their paper. In terms of absolute risk, current use of fluoroquinolones would, in the worst-case scenario, account for no more than 11 additional cases of retinal detachment per one million treatment episodes, they added. "For the physician caring for an inpatient with an indication for fluoroquinolone therapy, retinal detachment should not cross the physician's mind," Allan Brett of the University of South Carolina School of Medicine, said in an accompanying editorial. "But the next time an outpatient with no good indication for a quinolone asks for one 'because I got better last time I took it,' the physician might mention a remote possibility of retinal detachment among the many reasons for declining the request," Brett added.