Systemic fluoroquinolone treatment not a risk factor for uveitis, retinal detachment

Individuals who received systemic fluoroquinolone do not appear to have an increased risk of uveitis or retinal detachment, as shown in a study.

For the study, researchers used data from the Clinical Practice Research Datalink Aurum and GOLD UK primary care records databases and identified adults prescribed a fluoroquinolone or a comparator antibiotic (ie, cephalosporin). A total of 3,001,256 individuals in Aurum (median age 51 years, 63.1 percent women) and 434,754 in GOLD (median age 53 years, 63.5 percent women) were included in the analysis.

Weighted Cox regression and conditional Poisson regression were used to estimate the association of fluoroquinolone prescription with either uveitis or retinal detachment.

Compared with cephalosporin, fluoroquinolone did not contribute to an increased risk of uveitis. This was true at first treatment episode (adjusted hazard ratio [aHR], 0.91, 95 percent confidence interval [CI], 0.72–1.14) and over all treatment episodes (aHR, 1.07, 95 percent CI, 0.92–1.25).

Result for the risk of retinal detachment was similar, with no significant between-group difference seen at first treatment episode (aHR, 1.37, 95 percent CI, 0.80–2.36) and over all treatment episodes (aHR, 1.18, 95 percent CI, 0.84–1.65).

In the self-controlled case series, the adjusted rate ratios (aRRs) for uveitis associated with fluoroquinolone use vs nonuse were 1.13 (95 percent CI, 0.97–1.31) within 1–29 days of exposure, 1.16 (95 percent CI, 1.00–1.34) within 30–59 days, and 0.98 (95 percent CI, 0.74–1.31) within 60 days or longer. For retinal detachment, the corresponding aRRs were 1.15 (95 percent CI, 0.86–1.54) within 1–29 days of exposure, 0.94 (95 percent CI, 0.69–1.30) within 30–59 days, and 1.03 (95 percent CI, 0.59–1.78) within 60 days or longer.

In light of the findings, the researchers acknowledged that a small increase in risk of uveitis or retinal detachment with systemic fluoroquinolones could not be ruled out, but the estimated risk differences showed that any absolute increase in risk would be small and, hence, of limited clinical importance.