A recent patient brought to mind the possible link between fluorquinolone antibiotics (ciprofloxacin, moxifloxacin, levofloxacin, etc) and the risk of retinal tears or detachments. Fluoroquinolones are one of the most often prescribed antibiotics, and if there is such a risk, could affect a large number of people.
An article posted in JAMA in April 2012 revealed a possible link between these antibiotics and retinal detachments. The article was a case control study of 989,591 patients who took the antibiotic between 2000-2007. 4384 patients had experienced a retinal detachment. Statistically, current use of fluoroquinolones carried a higher risk of retinal detachment but recent use and past use did not.
This article does not prove that fluorquinolones were the cause of the detachments, but merely suggests that there might be a correlation. The proposed mechanism is that the drug may have a destructive effect on collagen and connective tissue. In fact, there is a known risk between fluoroquinolone use and tendon rupture. Since the vitreous contains collagen, this could be the mechanism that leads to the increased risk of retinal detachment or tears.
So, what is the take home message of this possible risk? As a patient, be aware that there is a theoretical risk of retinal detachments with the use of this drug. If you are a prescriber, educate your patients about the signs of retinal tears and detachment such as flashes and floaters. If you are currently using a fluorquinolone antibiotic and experience flashes, floaters, or other symptoms of a retinal detachment, you should contact your physician and an eye care professional. They will perform an dilated exam to look for retinal pathology.
This blog post is for informational purposes only. It is not intended to medical advice. Please seek the advice of a qualified professional.
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