Antiplatelet and Anticoagulant Drugs Do Not Affect Visual Outcome in Neovascular Age-Related Macular Degeneration in the BRAMD Trial

comparing Bevacizumab to Ranibizumab in Age-related Macular Degeneration (BRAMD) Trial Research Group

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12 Citations (Scopus)


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: Multicenter. STUDY POPULATION: Total of 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% vs 32%, P =.32, respectively). Similar results were found when analyses were restricted to aspirin users only. Conclusion: In our study, use of AP/AC medication was associated neither with visual decline nor with the occurrence of hemorrhages in patients with active N-AMD.

Original languageEnglish
Pages (from-to)130-137
Number of pages8
JournalAmerican Journal of Ophthalmology
Publication statusPublished - Mar 2018

Bibliographical note

Funding Information:
Funding/Support: This work was supported by a grant from ZonMW, the Netherlands Organisation for Health Research and Development projectnummer 170885606; MD Fonds, Utrecht, the Netherlands; the Stichting Nederlands Oog Onderzoek (SNOO), Rotterdam, The Netherlands; Rotterdamse Blindenbelangen Association, Rotterdam, The Netherlands; Oogfonds Nederland, Utrecht, The Netherlands; and Vereniging Trustfonds Erasmus Universiteit Rotterdam, Rotterdam, The Netherlands. Financial Disclosures: Reinier O. Schlingemann is an advisor of Novartis and Bayer (all in the Netherlands); Caroline C.W. Klaver received in-kind research funding from Topcon; she is an advisor of Novartis, Bayer, and Thea Pharma (all in the Netherlands). The following authors have no financial disclosures: Gabriëlle H.S. Buitendijk, Ann-Sofie M.E. Schauwvlieghe, and Johannes R. Vingerling. The authors attest that they meet the current ICMJE criteria for authorship.

Publisher Copyright:
© 2018 Elsevier Inc.

Research programs

  • EMC NIHES-01-64-01
  • EMC OR-01-60-01


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