zithromax and Retinal-Detachment

The risk of retinal detachment (RD) following exposure to fluoroquinolone (FQ) has been assessed in multiple studies, however, results have been mixed. This study was designed to estimate the risk of RD following exposure to FQ, other common antibiotics, and febrile illness not treated with antibiotics (FINTA) using a self-controlled case series (SCCS) study design to reduce risk of confounding from unreported patient characteristics.. Retrospective database analysis-SCCS.. Primary and Secondary Care.. 40,981 patients across 3 US claims databases (IBM® MarketScan® commercial and Medicare databases, Optum Clinformatics).. RD.. Exposures included FQ as a class of drugs, amoxicillin, azithromycin, trimethoprim with and without sulfamethoxazole, and FINTA. For the primary analysis, all drug formulations were included. For the post hoc sensitivity analyses, only oral tablets were included. Risk windows were defined as exposure period (or FINTA duration) plus 30 days. Patients of all ages with RD and exposures in 3 US claims databases between 2012 to 2017 were included. Diagnostics included p value calibration and pre-exposure outcome analyses. Incidence rate ratios (IRR) and 95% confidence interval (CI) comparing risk window time with other time were calculated.. Our primary analysis showed an increased risk for RD in the 30 days prior to exposure to FQ or trimethoprim without sulfamethoxazole. This risk decreased but remained elevated for 30 days following first exposure. Our post-hoc analysis, which excluded ophthalmic drops, showed no increased risk for RD at any time, with FQ and other antibiotics.. Our results did not suggest an association between FQ and RD. Oral FQ was not associated with an increased risk for RD during the pre- or post-exposure period.. ClinicalTrials.gov identifier: NCT03479736-March 21, 2018.

Topics: Aged; Amoxicillin; Anti-Bacterial Agents; Azithromycin; Delivery of Health Care; Fluoroquinolones; Humans; Medicare; Retinal Detachment; Retrospective Studies; Sulfamethoxazole; Trimethoprim; United States

Vasoproliferative retinal tumors are benign tumors of unknown origin often accompanied by vitreoretinal inflammation. A 21-year-old female patient presented with acute reduced unilateral visual acuity. A solid yellow vascularized lesion was present in the inferior temporal retina accompanied by localized retinal detachment and accumulation of hard exudations. The only finding was an increased Bartonella henselae titer. Persistence of uveitis and blurred vision led to therapy for Bartonella henselae with macrolide antibiotics and successful tumor regression was achieved by cryotherapy.

Topics: Angiomatosis, Bacillary; Anti-Bacterial Agents; Anti-Inflammatory Agents; Azithromycin; Bartonella henselae; Combined Modality Therapy; Cryosurgery; Drug Therapy, Combination; Female; Fluorescein Angiography; Follow-Up Studies; Humans; Immunoglobulin G; Ophthalmoscopes; Retinal Detachment; Retinal Diseases; Retinal Neovascularization; Ultrasonography; Uveitis, Intermediate; Young Adult

Topics: Anti-Bacterial Agents; Azithromycin; Chlamydia trachomatis; Humans; Male; Middle Aged; Retinal Detachment; Subretinal Fluid; Trachoma

To describe the clinical, optical coherence tomographic, and angiographic findings in patients with acute toxoplasmic retinochoroiditis (RC) associated with serous retinal detachment (SRD).. The study included 60 eyes with acute toxoplasmic RC.. Of 60 eyes, 14 (23.3%) were found to have SRD. The SRD was visible on fundus examination in 6 cases and detectable only by optical coherence tomography (OCT) in the 8 remaining cases. It involved the fovea in 9 eyes. There was evidence of associated choroidal ischemia on fluorescein angiography and indocyanine green angiography in 5 eyes. Findings seen at the acute stage gradually resolved over a period of 2-6 weeks in all patients.. SRD, accurately detected by OCT, is a common complication of acute toxoplasmic RC that should be considered as a potential cause of visual loss. Choroidal ischemia might contribute to the development of such complication.

Topics: Acute Disease; Adult; Antiprotozoal Agents; Azithromycin; Chorioretinitis; Female; Fluorescein Angiography; Humans; Indocyanine Green; Male; Prednisone; Pyrimethamine; Retinal Detachment; Tomography, Optical Coherence; Toxoplasmosis, Ocular; Treatment Outcome; Young Adult