TY - JOUR
T1 - Antiplatelet and Anticoagulant Drugs Do Not Affect Visual Outcome in Neovascular Age-Related Macular Degeneration in the BRAMD Trial
AU - comparing Bevacizumab to Ranibizumab in Age-related Macular Degeneration (BRAMD) Trial Research Group
AU - Buitendijk, Gabriëlle H.S.
AU - Schauwvlieghe, Ann Sofie M.E.
AU - Vingerling, Johannes R.
AU - Schlingemann, Reinier O.
AU - Klaver, C. C.W.
AU - Schlingemann, Reinier O.
AU - Verbraak, Frank D.
AU - van Schooneveld, Marie
AU - Wezel, Monique
AU - Stam, Henk
AU - Jansen-Kok, Christa
AU - Althoff, Ans
AU - Bakker, Douwe
AU - van der Zee, Annette
AU - Stam, Monique
AU - De Vries, Dick J.
AU - Vingerling, Johannes R.
AU - Naus-Postema, N. C.
AU - Hertoge, K. L.De Roo
AU - Klaver, C. C.W.
AU - Kilic, E.
AU - Noordzij, Yvonne
AU - Noordzij, Jeanette
AU - Vermij, Anjo
AU - Hooghart, Ada
AU - Dijkman, Greetje
AU - Boesten, Ingrid
AU - de Jonge, C. Kiewiet
AU - Kromhart- de Haas, M.
AU - Mollinger, Cora
AU - Zwaan, J. W.
AU - Brink, Lou
AU - Boolman, Anneke
AU - Hooymans, J. M.M.
AU - Kamminga, Nicole
AU - Huiskamp, Angela
AU - Postma, G.
AU - Meinen, Marijke
AU - Uwantege, L.
AU - Luurtsema, H. R.
AU - Eisses, J. F.
AU - de Lavalette, V. W.Ronardel
AU - De Pol, J. P.Van
AU - Hoyng, Carel B.
AU - de Vries, Agnes
AU - De Haan, R.
AU - Schauwvlieghe, A. M.E.
AU - van Dalen, J. J.W.
AU - Schauwvlieghe, A. M.E.
AU - van Leeuwen, R.
N1 - 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.
PY - 2018/3
Y1 - 2018/3
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=85041555370&partnerID=8YFLogxK
U2 - 10.1016/j.ajo.2018.01.003
DO - 10.1016/j.ajo.2018.01.003
M3 - Article
C2 - 29330064
SN - 0002-9394
VL - 187
SP - 130
EP - 137
JO - American Journal of Ophthalmology
JF - American Journal of Ophthalmology
ER -