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Gabrielle HS Buitendijk, Ann-Sofie M Schauwvlieghe, Johannes R Vingerling, Reinier Schlingemann, Caroline Klaver; Antiplatelet and anticoagulant drugs do not affect visual acuity in neovascular age-related macular degeneration. The BRAMD Study. Invest. Ophthalmol. Vis. Sci. 2017;58(8):3215.
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To determine if the use of antiplatelet or anticoagulant (AP/AC) therapy influences visual acuity in patients with active neovascular age-related macular degeneration (N-AMD).
Baseline data from 330 eyes with active N-AMD from 330 patients from the BRAMD study was used, a comparative multi-center study between bevacizumab and ranibizumab in the Netherlands. Patients underwent an extensive ophthalmic examination at baseline before initiation of anti-angiogenic therapy. Visual acuity was categorized in acceptable 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 hemorrhages, located retinal or subretinal in the posterior pole. Information on use of AP/AC therapy was obtained through interview. Logistic regression analysis was used to determine associations between AP/AC therapy and outcomes: visual acuity levels and subsequently presence of retinal hemorrhages. Frequency of hemorrhages in users and non-users stratified for visual acuity categories was analyzed with ANCOVA.
In total, 31.8% of the patients used AP/AC therapy, of which 74% was aspirin. AP/AC therapy was associated with a lower risk of visual impairment (adjusted odds ratio (OR) 0.52 (95% confidence interval (CI) 0.28-0.999) as well as severe visual impairment (adjusted OR 0.41 (95% CI 0.20-0.84). Although presence of hemorrhages was associated with lower visual acuity (P=0.008, ANCOVA), patients on AP/AC therapy presented with a lower frequency of hemorrhages,19% versus 35% in nonusers, respectively (P=0.0004, ANCOVA). Similar results were found for aspirin users.
In our study, use of AP/AC therapy did not affect visual acuity in patients with active N-AMD and did not lead to more hemorrhages in comparison to nonusers.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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