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.
Acta Ophthalmol. 2016 Aug;94(5):e251-9. doi: 10.1111/aos.12931. Epub 2016 Feb 5.
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.
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.
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.
In light of the current available evidence, systemic fluoroquinolones do not seem to be associated with retinal detachment.
已经进行了几项药物流行病学研究，评估全身氟喹诺酮类药物与视网膜脱离相关的风险。本荟萃分析旨在根据现有最佳科学证据调查这种相关性。
进行文献检索，以确定评估全身氟喹诺酮类药物与视网膜脱离相关风险的相关研究。进行荟萃分析以汇总率比 (RR)。进行荟萃回归分析，旨在评估氟喹诺酮类药物使用与视网膜脱离诊断或治疗风险估计之间的时间间隔对风险估计的影响。
纳入了来自 7 篇出版物的 10 项观察性研究。总体而言，氟喹诺酮类药物与视网膜脱离风险增加无关 [RR 1.47 (95% CI 0.95-2.27)：p = 0.09；I(2) = 92.8%]。当根据不同的研究设计进行分层分析时，回顾性队列研究的结果具有统计学意义 [RR 1.87 (95% CI 1.36-2.58)；p < 0.001；I(2) = 0.0%]，以及基于病例对照研究中氟喹诺酮类药物过去使用者的数据 [RR 1.07 (95% CI 1.01-1.12)；p = 0.01；I(2) = 0.0%]。根据荟萃回归分析，氟喹诺酮类药物处方与视网膜脱离发生之间的不同时间间隔不会导致视网膜脱离的风险发生变化。在仅评估孔源性视网膜脱离的研究中，以及在评估无需事先看眼科医生即可纳入的患者的研究中，均未发现具有统计学意义的结果。
根据现有证据，全身氟喹诺酮类药物似乎与视网膜脱离无关。
