School of Pharmacy, Sungkyunkwan University, Suwon, South Korea.
Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
J Antimicrob Chemother. 2018 Dec 1;73(12):3442-3453. doi: 10.1093/jac/dky336.
To determine whether or not fluoroquinolone use increases the incidence of retinal detachment.
Self-controlled case series analysis.
Participants were identified using the South Korean National Health Insurance Database between 1 January 2004 and 31 December 2015. A total of 15 134 patients who experienced rhegmatogenous retinal detachment (RRD) with at least one prescription of a fluoroquinolone were included.
Incidence rate ratios (IRRs) and their 95% CIs were calculated using conditional Poisson regression. The main outcome measure was a recorded diagnosis of RRD (ICD-10: H33.0) with a claim for the surgical code for RRD.
We found an increased risk of retinal detachment in the first 1-30 days following the initiation of fluoroquinolone therapy (IRR 1.85; 95% CI 1.71-1.95), which rose for the 31-60 days period (IRR 2.05; 95% CI 1.43-2.95) but remained constant after more than 60 days (IRR 1.25; 95% CI 0.75-2.10). However, the elevated risk was also found in the 1-30 day period prior to the initiation of fluoroquinolone therapy (IRR 1.58; 95% CI 1.49-1.68) and also 31-60 days before medication use (IRR 1.11; 95% CI 1.03-1.19).
Our case-based study indicated that the risk after fluoroquinolone exposure doubled; however, the risk profile before and after fluoroquinolone use means that the association between fluoroquinolone use and retinal detachment might not be a causal relationship.
确定氟喹诺酮类药物的使用是否会增加视网膜脱离的发生率。
自身对照病例系列分析。
参与者是通过韩国国家健康保险数据库于 2004 年 1 月 1 日至 2015 年 12 月 31 日期间确定的。共纳入了 15134 名至少有一次氟喹诺酮类药物处方的孔源性视网膜脱离（RRD）患者。
使用条件泊松回归计算发病率比（IRR）及其 95%置信区间。主要观察指标是记录的 RRD 诊断（ICD-10：H33.0）和 RRD 手术代码的索赔。
我们发现氟喹诺酮类药物治疗开始后 1-30 天内视网膜脱离的风险增加（IRR 1.85；95%CI 1.71-1.95），在 31-60 天期间上升（IRR 2.05；95%CI 1.43-2.95），但在 60 天以上后保持不变（IRR 1.25；95%CI 0.75-2.10）。然而，在氟喹诺酮类药物治疗开始前的 1-30 天内也发现了这种风险升高（IRR 1.58；95%CI 1.49-1.68），在开始用药前 31-60 天内也发现了风险升高（IRR 1.11；95%CI 1.03-1.19）。
我们的基于病例的研究表明，氟喹诺酮类药物暴露后的风险增加了一倍；然而，氟喹诺酮类药物使用前后的风险状况意味着氟喹诺酮类药物使用与视网膜脱离之间的关联可能不是因果关系。
