Association between fluoroquinolones and retinal detachment: insights from a large German health claims-based cohort study

Abstract Purpose Real-world evidence on fluoroquinolone-associated retinal detachment is contradictory. Therefore, we aim to examine the association between newly prescribed fluoroquinolones and the occurrence of retinal detachment with recent data from a large central European country. Methods A co...

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Main Authors: Julia Wicherski, Jonas Peltner, Cornelia Becker, Katrin Schüssel, Gabriela Brückner, Andreas Schlotmann, Helmut Schröder, Winfried V. Kern, Britta Haenisch
Format: Article
Language:English
Published: BMC 2025-08-01
Series:BMC Ophthalmology
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Online Access:https://doi.org/10.1186/s12886-025-04284-5
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author Julia Wicherski
Jonas Peltner
Cornelia Becker
Katrin Schüssel
Gabriela Brückner
Andreas Schlotmann
Helmut Schröder
Winfried V. Kern
Britta Haenisch
author_facet Julia Wicherski
Jonas Peltner
Cornelia Becker
Katrin Schüssel
Gabriela Brückner
Andreas Schlotmann
Helmut Schröder
Winfried V. Kern
Britta Haenisch
author_sort Julia Wicherski
collection DOAJ
description Abstract Purpose Real-world evidence on fluoroquinolone-associated retinal detachment is contradictory. Therefore, we aim to examine the association between newly prescribed fluoroquinolones and the occurrence of retinal detachment with recent data from a large central European country. Methods A cohort study with an active comparator new user design was conducted. Dispensings of fluoroquinolone episodes were compared to a group of reference antibiotic episodes (amoxicillin, amoxicillin clavulanic acid, azithromycin, cefuroxime, cephalexin, clindamycin, sulfamethoxazole-trimethoprim, and doxycycline). Data from one of the largest statutory health insurances in Germany, the AOK, were used to follow up individuals with new antibiotic dispensing during the years 2014–2018 for the occurrence of retinal detachment. Piece-wise exponential additive mixed models adjusted for person-time, age, gender, comorbidities, year, and quarter at index were applied to estimate adjusted hazard ratios (aHR) with corresponding 95% confidence intervals (95% CI). Results In total, 15,232,585 antibiotic episodes were included in the cohort of which 0.05% episodes had an incident retinal detachment. The covariate-adjusted hazard ratio for fluoroquinolone episodes was 1.01 [0.95;1.08]. Likewise, in the propensity score-matched cohort the covariate-adjusted hazard ratio was 0.99 [0.92;1.07]. Moreover, there was little evidence for differences in age and gender subgroups, by follow-up time, selection of active comparator agent, dosage category, or censoring approach. Conclusions This large German cohort study found no meaningful real-world evidence for the association between fluoroquinolones and retinal detachment compared to a group of active comparator antibiotics.
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spelling doaj-art-17ed17bb150d49a4a9827cc2d6d70b2d2025-08-20T03:45:56ZengBMCBMC Ophthalmology1471-24152025-08-012511810.1186/s12886-025-04284-5Association between fluoroquinolones and retinal detachment: insights from a large German health claims-based cohort studyJulia Wicherski0Jonas Peltner1Cornelia Becker2Katrin Schüssel3Gabriela Brückner4Andreas Schlotmann5Helmut Schröder6Winfried V. Kern7Britta Haenisch8Research Division, Pharmacoepidemiology, Federal Institute for Drugs and Medical Devices (BfArM)Research Division, Pharmacoepidemiology, Federal Institute for Drugs and Medical Devices (BfArM)Research Division, Pharmacoepidemiology, Federal Institute for Drugs and Medical Devices (BfArM)Research Institute of AOK (WIdO)Research Institute of AOK (WIdO)Research Institute of AOK (WIdO)Research Institute of AOK (WIdO)Division of Infectious Diseases, Department of Medicine II, Faculty of Medicine and Medical Centre, University of FreiburgResearch Division, Pharmacoepidemiology, Federal Institute for Drugs and Medical Devices (BfArM)Abstract Purpose Real-world evidence on fluoroquinolone-associated retinal detachment is contradictory. Therefore, we aim to examine the association between newly prescribed fluoroquinolones and the occurrence of retinal detachment with recent data from a large central European country. Methods A cohort study with an active comparator new user design was conducted. Dispensings of fluoroquinolone episodes were compared to a group of reference antibiotic episodes (amoxicillin, amoxicillin clavulanic acid, azithromycin, cefuroxime, cephalexin, clindamycin, sulfamethoxazole-trimethoprim, and doxycycline). Data from one of the largest statutory health insurances in Germany, the AOK, were used to follow up individuals with new antibiotic dispensing during the years 2014–2018 for the occurrence of retinal detachment. Piece-wise exponential additive mixed models adjusted for person-time, age, gender, comorbidities, year, and quarter at index were applied to estimate adjusted hazard ratios (aHR) with corresponding 95% confidence intervals (95% CI). Results In total, 15,232,585 antibiotic episodes were included in the cohort of which 0.05% episodes had an incident retinal detachment. The covariate-adjusted hazard ratio for fluoroquinolone episodes was 1.01 [0.95;1.08]. Likewise, in the propensity score-matched cohort the covariate-adjusted hazard ratio was 0.99 [0.92;1.07]. Moreover, there was little evidence for differences in age and gender subgroups, by follow-up time, selection of active comparator agent, dosage category, or censoring approach. Conclusions This large German cohort study found no meaningful real-world evidence for the association between fluoroquinolones and retinal detachment compared to a group of active comparator antibiotics.https://doi.org/10.1186/s12886-025-04284-5Active comparator new user designAdministrative cohortReal-world dataFluoroquinolonesAdverse drug reactions
spellingShingle Julia Wicherski
Jonas Peltner
Cornelia Becker
Katrin Schüssel
Gabriela Brückner
Andreas Schlotmann
Helmut Schröder
Winfried V. Kern
Britta Haenisch
Association between fluoroquinolones and retinal detachment: insights from a large German health claims-based cohort study
BMC Ophthalmology
Active comparator new user design
Administrative cohort
Real-world data
Fluoroquinolones
Adverse drug reactions
title Association between fluoroquinolones and retinal detachment: insights from a large German health claims-based cohort study
title_full Association between fluoroquinolones and retinal detachment: insights from a large German health claims-based cohort study
title_fullStr Association between fluoroquinolones and retinal detachment: insights from a large German health claims-based cohort study
title_full_unstemmed Association between fluoroquinolones and retinal detachment: insights from a large German health claims-based cohort study
title_short Association between fluoroquinolones and retinal detachment: insights from a large German health claims-based cohort study
title_sort association between fluoroquinolones and retinal detachment insights from a large german health claims based cohort study
topic Active comparator new user design
Administrative cohort
Real-world data
Fluoroquinolones
Adverse drug reactions
url https://doi.org/10.1186/s12886-025-04284-5
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