Department of Ophthalmology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Invest Ophthalmol Vis Sci. 2012 Jun 20;53(7):3801-5. doi: 10.1167/iovs.12-9604.
To determine the associations between the use of antithrombotic drugs and incident open-angle glaucoma (OAG).
Ophthalmic 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.
确定抗血栓药物的使用与原发性开角型青光眼（OAG）发病之间的相关性。
在基线和随访中，对前瞻性人群为基础的鹿特丹研究的 3939 名参与者进行眼科检查，包括眼压和视野测量，这些参与者在基线时没有 OAG。在随访期间连续监测抗血栓药物的使用情况。将抗血栓药物分为抗凝剂和血小板聚集抑制剂。使用 Cox 回归评估抗血栓药物与新发 OAG 之间的相关性；该模型调整了年龄、性别、基线眼压和降眼压治疗、青光眼家族史和近视。使用多元线性回归分析抗血栓药物与随访时眼压之间的关系。
在平均 9.8 年的随访期间，有 108 名参与者（2.7%）患上了 OAG。抗凝剂使用的风险比为 0.90（95%置信区间[CI]，0.55-1.48；P=0.69），血小板聚集抑制剂使用的风险比为 0.80（0.53-1.21；P=0.28）。随着抗凝剂使用时间的延长，OAG 发病风险没有降低或增加的趋势（趋势检验 P 值为 0.84），也没有随着血小板聚集抑制剂使用时间的延长而降低或增加的趋势（P 值为 0.59）。抗凝剂有显著的降眼压作用（-0.31mmHg；95%CI，-0.58 至-0.04mmHg；P=0.025），但血小板聚集抑制剂没有这种作用（P=0.06）。在对全身使用β受体阻滞剂进行额外调整后，抗凝剂的降眼压作用消失。
使用抗凝剂或血小板聚集抑制剂似乎与 OAG 发病无关。
