Exploration of fluoroquinolone-induced retinal pigment epithelium layer changes in the pathogenesis of macular degeneration

Purpose: Fluoroquinolone toxicity studies in animals (cats, rabbits and mice) showed that acute retinal degenerations appear clinically related to phototoxicity. The aim of this study was to evaluate the association between the administration of oral fluoroquinolone and the onset of clinically or subclinically detectable acute retinal degeneration in humans. Material and Methods: This study included patients that received oral fluoroquinolone treatment (ciprofloxacin, levofloxacin or moxifloxacin) for variable systemic diseases diagnosed by the Department of Urology and Infectious Diseases (study group, n=76), and age and sex matched otherwise healthy subjects (control group, n=50). All the subjects underwent a detailed ophthalmologic examination including tests for visual acuity, intraocular pressures, color vision, photostress recovery time and contrast sensitivity measurements, central foveal thickness, subfoveal choroidal thickness, ganglion cell complex thickness and 10/2 Humphrey visual field test. Color fundus and fundus autofluorescence photographs were also obtained. Examinations and tests were repeated at 1st week and 1st month in the study group. Results: There was no statistically significant difference among visual acuity, intraocular pressure, photostress recovery time, color vision, contrast sensitivity measurements, central foveal thickness, subfoveal choroidal thickness, average ganglion cell complex thickness, superior ganglion cell complex thickness, inferior ganglion cell complex thickness, focal loss volume, global loss volume, mean deviation, pattern standard deviation values in treatment group at baseline, 1st week and 1st month (p > 0.05, for the comparison of each parameters). There was not any alteration among color fundus and fundus autofluorescence photographs obtained at baseline, 1st week and 1st month in treatment group. All parameters within the study and control groups were similar throughout the study period (p > 0.05, for the comparison of each parameter). Conclusion: This study evaluated the association between the administration of oral fluoroquinolone and the onset of acute retinal degeneration. Preliminary results of this study showed that use of oral fluoroquinolone had no detectable impact on retinal degeneration at acute phase.