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Michael W. Marcus, Rogier P. H. M. Müskens, Wishal D. Ramdas, Roger C. W. Wolfs, Paulus T. V. M. de Jong, Johannes R. Vingerling, Albert Hofman, Bruno H. C. Stricker, Nomdo M. Jansonius; Antithrombotic Medication and Incident Open-Angle Glaucoma. Invest. Ophthalmol. Vis. Sci. 2012;53(7):3801-3805. doi: 10.1167/iovs.12-9604.
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determine the associations between the use of antithrombotic drugs and incident open-angle glaucoma (OAG).
examinations including measurements of the IOP and perimetry were performed at baseline and follow-up in 3939 participants of the prospective population-based Rotterdam Study who did not have OAG at baseline. The use of antithrombotic drugs was monitored continuously during follow-up. Antithrombotic drugs were stratified into anticoagulants and platelet aggregation inhibitors. Associations between incident OAG and the use of antithrombotic drugs were assessed using Cox regression; the model was adjusted for age, sex, baseline IOP and IOP-lowering treatment, family history of glaucoma, and myopia. Associations between antithrombotic drugs and IOP at follow-up were analyzed with multiple linear regression.
During a mean follow-up of 9.8 years, 108 participants (2.7%) developed OAG. The hazard ratio for anticoagulant use was 0.90 (95% confidence interval [CI], 0.55–1.48; P = 0.69) and for platelet aggregation inhibitors 0.80 (0.53–1.21; P = 0.28). There was no trend towards a reduced or increased risk of incident OAG with prolonged anticoagulant use (P value for trend 0.84) or platelet aggregation inhibitor use (0.59). There was a significant IOP-lowering effect of anticoagulants (−0.31 mm Hg; 95% CI, −0.58 to −0.04 mm Hg; P = 0.025) but not of platelet aggregation inhibitors (P = 0.06). The IOP-lowering effect of anticoagulants disappeared after additional adjustment for the use of systemic beta-blockers.
Use of anticoagulants or platelet aggregation inhibitors appears not to be associated with incident OAG.
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