Association between Antiplatelet or Anticoagulant Drugs and Retinal or Subretinal Hemorrhage in the Comparison of Age-Related Macular Degeneration Treatments Trials.
Association between Antiplatelet or Anticoagulant Drugs and Retinal or Subretinal Hemorrhage in the Comparison of Age-Related Macular Degeneration Treatments Trials.
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DOI：
10.1016/j.ophtha.2015.09.046
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发表时间：
2016-02
期刊：
影响因子：
13.7
通讯作者：
Comparison of Age-Related Macular Degeneration Treatments Trials Research Group
中科院分区：
文献类型：
--
作者：
Ying GS;Maguire MG;Daniel E;Grunwald JE;Ahmed O;Martin DF;Comparison of Age-Related Macular Degeneration Treatments Trials Research Group
To evaluate the association between use of antiplatelet (AP) or anticoagulant (AC) drugs and retinal/subretinal hemorrhage in participants with neovascular age-related macular degeneration (AMD) in the Comparison of AMD Treatments Trials (CATT). Cohort study within CATT. 1185 CATT participants with untreated active neovascular AMD were interviewed for use of AP/AC drugs. Trained readers evaluated photographs for the presence and size of retinal/subretinal hemorrhage associated with the neovascular lesion at baseline and years 1 and 2. Associations between use of AP/AC drugs and hemorrhage were evaluated among all participants and by baseline hypertension status using Fisher exact test and multivariate logistic regression models. Odds ratio for association with AP/AC use. Among 1165 participants with gradable photographs, 724 (62.1%) had retinal/subretinal hemorrhage at baseline, 84.4% of hemorrhages were ≤ 1 DA, 8.1% were 1 to 2 DA, and 7.5% were >2 DA. 608 (52.2%) participants used AP/AC drugs at baseline, including 514 (44.1%) AP only, 77 (6.6%) AC only, and 17 (1.5%) both AP and AC. Participants with retinal/subretinal hemorrhage at baseline were comparable to those without retinal/subretinal hemorrhage except that they were older (80 vs. 78 years, p<0.0001) and had lower diastolic blood pressure (74.9 vs. 76.2 mmHg, p=0.03). Retinal/subretinal hemorrhage was present in 64.5% of AP/AC users and in 59.6% of non-users (p=0.09), the adjusted odds ratio (OR) was 1.18 (95% CI: 0.91–1.51, p=0.21). Neither presence nor size of baseline retinal/subretinal hemorrhage was associated with the type, dose or duration of AP/AC use. Forty-four (4.08%) of 1078 participants had retinal/subretinal hemorrhage detected on 1-year or 2-year photographs; these hemorrhages were not associated with AP/AC use at baseline (p=0.28) or during follow-up (p=0.64). Among participants with hypertension (N=807), AP/AC use was associated with higher rate of retinal/subretinal hemorrhage at baseline (66.8% vs. 56.4%, adjusted OR=1.48, p=0.01), but not size of retinal/subretinal hemorrhage (p=0.41). The majority of retinal/subretinal hemorrhages in eyes enrolled in CATT were <1 DA. Among all CATT participants, AP/AC use was not significantly associated with hemorrhage, but was significantly associated with hemorrhage in participants with hypertension.
