TY - JOUR
T1 - Antiplatelet and anticoagulant drugs do not affect visual outcome in neovascular age-related macular degeneration in the BRAMD trial
AU - Buitendijk, Gabriëlle H S
AU - Schauwvlieghe, Ann-Sofie M E
AU - Vingerling, Johannes R
AU - Schlingemann, Reinier O
AU - Klaver, Caroline C W
N1 - Copyright © 2018. Published by Elsevier Inc.
PY - 2018
Y1 - 2018
N2 - PURPOSE: To determine if use of antiplatelet or anticoagulant (AP/AC) medication influences visual acuity in patients with active neovascular age-related macular degeneration (N-AMD).DESIGN: Retrospective analysis of data from a randomized controlled trial METHODS: Setting: Multi-center STUDY POPULATION: 330 patients with active N-AMD from the BRAMD study, a comparative trial between bevacizumab and ranibizumab in the Netherlands.OBSERVATION PROCEDURES: Patients underwent an extensive ophthalmic examination. Visual acuity was categorized into functional vision (best corrected visual acuity (BCVA) >=0.5), visual impairment (BCVA < 0.5), and severe visual impairment (BCVA<0.3). Fundus photographs were graded for presence of retinal or subretinal hemorrhages. Information on AP/AC medication was obtained through interview. Logistic regression analysis was used to determine associations between AP/AC medication and outcomes. Frequency of hemorrhages in users and non-users stratified for visual acuity categories was analyzed with ANCOVA.MAIN OUTCOME MEASURES: BCVA and presence of hemorrhages.RESULTS: In total, 40.9% of the patients used AP/AC medication, of which 73.3% was aspirin. AP/AC use was not associated with visual impairment (adjusted odds ratio (OR) 0.79 (95% confidence interval (CI) 0.43-1.44), or severe visual impairment (adjusted OR 0.75 (95% CI 0.40-1.43). Patients on AP/AC presented with comparable frequencies of hemorrhages (27% versus 32%, P=0.29, respectively). Similar results were found when analyses were restricted to aspirin users only.CONCLUSION: In our study, use of AP/AC medication was neither associated with visual decline nor with the occurrence of hemorrhages in patients with active N-AMD.
AB - PURPOSE: To determine if use of antiplatelet or anticoagulant (AP/AC) medication influences visual acuity in patients with active neovascular age-related macular degeneration (N-AMD).DESIGN: Retrospective analysis of data from a randomized controlled trial METHODS: Setting: Multi-center STUDY POPULATION: 330 patients with active N-AMD from the BRAMD study, a comparative trial between bevacizumab and ranibizumab in the Netherlands.OBSERVATION PROCEDURES: Patients underwent an extensive ophthalmic examination. Visual acuity was categorized into functional vision (best corrected visual acuity (BCVA) >=0.5), visual impairment (BCVA < 0.5), and severe visual impairment (BCVA<0.3). Fundus photographs were graded for presence of retinal or subretinal hemorrhages. Information on AP/AC medication was obtained through interview. Logistic regression analysis was used to determine associations between AP/AC medication and outcomes. Frequency of hemorrhages in users and non-users stratified for visual acuity categories was analyzed with ANCOVA.MAIN OUTCOME MEASURES: BCVA and presence of hemorrhages.RESULTS: In total, 40.9% of the patients used AP/AC medication, of which 73.3% was aspirin. AP/AC use was not associated with visual impairment (adjusted odds ratio (OR) 0.79 (95% confidence interval (CI) 0.43-1.44), or severe visual impairment (adjusted OR 0.75 (95% CI 0.40-1.43). Patients on AP/AC presented with comparable frequencies of hemorrhages (27% versus 32%, P=0.29, respectively). Similar results were found when analyses were restricted to aspirin users only.CONCLUSION: In our study, use of AP/AC medication was neither associated with visual decline nor with the occurrence of hemorrhages in patients with active N-AMD.
KW - Journal Article
U2 - 10.1016/j.ajo.2018.01.003
DO - 10.1016/j.ajo.2018.01.003
M3 - Article
C2 - 29330064
SN - 0002-9394
VL - 187
SP - 130
EP - 137
JO - American Journal of Ophthalmology
JF - American Journal of Ophthalmology
ER -