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Gui-Shuang Ying, Maureen G Maguire, Ebenezer Daniel, Juan E Grunwald, Daniel F Martin, ; Association between Antiplatelet or Anticoagulant Drugs and Retinal Hemorrhage in the Comparison of AMD Treatments Trials (CATT). Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):2569.
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To evaluate the association between use of antiplatelet (AP) or anticoagulant (AC) drugs and retinal hemorrhage in CATT participants with neovascular age-related macular degeneration (AMD).
1185 CATT participants with untreated active choroidal neovascularization (CNV) secondary to AMD were enrolled. At baseline, trained readers at the CATT Photograph Reading Center evaluated on baseline fundus photographs, the presence and size (≤1, 1 to ≤2, >2 DA) of retinal hemorrhage associated with the neovascular lesion. At enrollment, the participants were interviewed for current use of AP/AC drugs (aspirin, warfarin, clopidogrel, etc.) including the type, dose, frequency and start date. The associations between use of AP/AC drugs and retinal hemorrhage at baseline were evaluated using Fisher exact test and logistic regression with adjustment for age, gender, smoking status, diabetes, medical history of cardiovascular diseases, and bilaterality of CNV.
Among 1165 CATT participants with gradable photographs, 724 (62.1%) had retinal hemorrhage at baseline, the majority (84%) of hemorrhages were ≤1 DA, 59 (8.1%) were 1 to 2 DA, and 54 (7.5%) were >2 DA. 608 (52.2%) participants used AP/AC at baseline (476 used aspirin, 98 used warfarin, 80 used clopidogrel), 514 (44.1%) used AP only, 77 (6.6%) used AC only, and 17 (1.5%) used both AP and AC. Participants with retinal hemorrhage at baseline were comparable to those without retinal 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 hemorrhage was present in 64.5% of AP/AC users and in 59.6% of non-users (p=0.09), the adjusted odds ratio was 1.18 (95% CI: 0.91-1.51, p=0.21). There is no significant association between use of AP/AC and size of retinal hemorrhage (p=0.34). No association was identified between type, dose or duration of AP/AC use and presence of retinal hemorrhage (Table 1).
Among the CATT participants with active neovascular AMD, the use of antiplatelet and anticoagulant drugs was not significantly associated with retinal hemorrhage at baseline.
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