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视网膜分支静脉阻塞眼中的全身抗血小板药物和抗凝剂。

Systemic antiplatelet agents and anticoagulants in eyes with branch retinal vein occlusion.

作者信息

Singh Pali P, Borkar Durga S, Robbins Cason B, Kim Jane S, Birnbaum Faith, Gomez-Caraballo Maria, Thomas Akshay S, Fekrat Sharon

机构信息

Duke University School of Medicine, Durham, NC, USA.

Duke Eye Center, Duke University, Durham, NC, USA.

出版信息

Ther Adv Ophthalmol. 2021 Sep 2;13:25158414211040894. doi: 10.1177/25158414211040894. eCollection 2021 Jan-Dec.

Abstract

PURPOSE

The purpose of this study was to investigate the effect of systemic antiplatelet agents and anticoagulants on the structural and functional outcomes of eyes with branch retinal vein occlusion (BRVO).

METHODS

A retrospective longitudinal cohort study was performed on BRVO patients evaluated at a single tertiary care referral center between 2009 and 2017. Medical records were reviewed for antiplatelet agent and anticoagulant use including aspirin, clopidogrel, warfarin, rivaroxaban, apixaban, or dabigatran prior to BRVO onset. In addition, optical coherence tomography (OCT) parameters, clinical outcomes, and treatment patterns were also recorded.

RESULTS

A total of 354 BRVO eyes were identified with a mean follow-up time of 36 months. Antiplatelet or anticoagulant use was associated with presence of cystoid macular edema (CME) at presentation after controlling for potential confounding variables in a multivariate logistic regression. Multivariate regression also revealed an association between foveal hemorrhage at presentation and use of antiplatelet or anticoagulant medications. There were no significant differences in visual acuity or prevalence of CME at the final visit in those with antiplatelet/anticoagulant use compared to those not on these agents.

CONCLUSION

Although the use of systemic antiplatelet or anticoagulant agents was associated with increased prevalence of CME and foveal hemorrhage at presentation of BRVO, the use of these medications was not associated with different visual or structural outcomes at the final visit.

摘要

目的

本研究旨在探讨全身应用抗血小板药物和抗凝剂对视网膜分支静脉阻塞(BRVO)患者眼部结构和功能转归的影响。

方法

对2009年至2017年间在一家三级医疗转诊中心接受评估的BRVO患者进行回顾性纵向队列研究。回顾病历以了解BRVO发病前抗血小板药物和抗凝剂的使用情况,包括阿司匹林、氯吡格雷、华法林、利伐沙班、阿哌沙班或达比加群。此外,还记录了光学相干断层扫描(OCT)参数、临床转归和治疗模式。

结果

共纳入354只BRVO患眼,平均随访时间为36个月。在多因素逻辑回归中控制潜在混杂变量后,抗血小板或抗凝剂的使用与就诊时黄斑囊样水肿(CME)的存在相关。多因素回归还显示就诊时黄斑出血与抗血小板或抗凝药物的使用之间存在关联。与未使用这些药物的患者相比,使用抗血小板/抗凝剂的患者在最后一次随访时的视力或CME患病率无显著差异。

结论

尽管全身应用抗血小板或抗凝剂与BRVO就诊时CME和黄斑出血的患病率增加相关,但在最后一次随访时,使用这些药物与不同的视力或结构转归无关。

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