Fig 1.
Graphical representation of all time intervals described in this study.
For example: patient A had a baseline observation period that began approximately 6 months before 01/01/2012, a FQ exposure after the end of the baseline observation period, a retinal detachment after the end of the risk window for that exposure and left the study before 03/31/2017. Patient C had a baseline observation period that began after 04/01/2012, a FQ exposure after the end of the baseline observation period, a retinal detachment within the risk period for that exposure and left the study before 03/31/2017. Patient D had a baseline observation period that began after 04/01/2012, a FQ exposure after the end of the baseline observation period, a retinal detachment after the end of the risk period for that exposure, second exposure after the retinal detachment and ceased to have observations at the end of the study period, i.e., 03/31/2017.
Table 1.
Characteristics and exposure case count for patients with RD.
Fig 2.
Timeline of RD Events, in each database, from 60 days before to 60 days after first FQ exposure.
FQ exposure included all types of formulations. Red bars indicate that events occurred concurrently with the FQ risk window, whereas blue bars indicate event occurrences outside of the risk window. A spike of RD events was observed prior to the first day of FQ exposure. 2A: Exposure timeline in OPTUMEXTDOD; 2B: Exposure timeline in IBMCOM; 2C: Exposure timeline in IBMMDCR.
Fig 3.
Timeline of RD Events, in each database, from 60 days before to 60 days after first FQ exposure.
FQ exposure included oral tablets only. Red bars indicate that events occurred concurrently with the FQ risk window, whereas blue bars indicate event occurrences outside of the risk window. 3A: Exposure timeline in OPTUMEXTDOD; 3B: Exposure timeline in IBMCOM; 3C: Exposure timeline in IBMMDCR. In contrast to Fig 2, there is no exposure peak in the days just before the retinal detachment. RD events were randomly distributed before and after the first date of FQ exposure.
Fig 4.
Incidence risk ratios (IRR) by exposure and database.
Asterisks identify statistically meaningful findings based on calibrated p values. Risks associated with exposures that included tablets only are shown in blue lines whereas risks associated with exposures that included all formulations are shown in orange lines. For fluoroquinolone exposures and for trimethoprim without sulfamethoxazole exposures, there is a substantial and statistically significant association of RD with exposure across all databases when all formulations, including topical ophthalmic formulations are included. When only oral exposures are included, the magnitude of this this association for these two medications becomes much smaller across all databases and the association loses statistical significance except in the panel for trimethoprim without sulfamethoxazole in the IBMMCDR database.