Original articleAssociation between Antiplatelet or Anticoagulant Drugs and Retinal or Subretinal Hemorrhage in the Comparison of Age-Related Macular Degeneration Treatments Trials
Section snippets
Methods
Details on the study design and methods have been reported in our previous publications18, 19 and on ClinicalTrials.gov (identifier NCT00593450). Only the major features related to this article are described here.
Characteristics of Antiplatelet or Anticoagulant Use
Among 1185 CATT participants, 1165 participants with gradable fundus photographs for determination of retinal or subretinal hemorrhage were included in this study. Among these 1165 participants, 608 (52.2%) used 1 or more antiplatelet or anticoagulant drugs at baseline, including 514 (44.1%) with antiplatelet drugs only, 77 (6.6%) with anticoagulant drugs only, and 17 (1.5%) with both antiplatelet and anticoagulant drugs. Among 608 participants who used antiplatelet or anticoagulant drugs, most
Discussion
Within the CATT, more than half of participants had retinal or subretinal hemorrhage at baseline, and most hemorrhages (84%) were smaller than 1 DA. There was no overall association between use of antiplatelet or anticoagulant drugs and the presence or size of retinal or subretinal hemorrhage. This lack of association was consistent whether we considered antiplatelet drugs only, anticoagulant drugs only, each specific antiplatelet or anticoagulant drug, or all antiplatelet or anticoagulant
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Cited by (38)
Associations and Outcomes of Patients with Submacular Hemorrhage Secondary to Age-related Macular Degeneration in the IVAN Trial
2022, American Journal of OphthalmologyCitation Excerpt :The Comparison of AMD Treatments Trials (CATT) changed their protocol to allow patients with SMH of greater than 50% of lesion size to be enrolled during the course of the study.14 They found that patients with any degree of SMH were older, and similarly we found a difference in the mean age of 2 years between patients with SMH compared with those without.1 Older age is a common risk factor for diseases affecting small blood vessels owing to the decrease in vascular elasticity and compliance associated with microscopic degenerative changes and an increased risk of cardiovascular comorbidities.15–17
The Timing of Large Submacular Hemorrhage Secondary to Age-Related Macular Degeneration Relative to Anti–VEGF Therapy
2021, Ophthalmology RetinaCitation Excerpt :However, another study of AMD patients receiving anti-VEGF treatment found no significant difference in intraocular hemorrhage rates with anticoagulation or antiplatelet use.20 Similarly, studies specifically analyzing retinal or subretinal hemorrhage risk in AMD noted no significant association with anticoagulation or antiplatelet therapy.18,21 The prevalence of anticoagulation or antiplatelet use in AMD patients has been described to be between 49% and 61%,19–21 similar to the anticoagulation or antiplatelet use in our patients of 60%.
Baseline characteristics and age-related macular degeneration in participants of the “ASPirin in Reducing Events in the Elderly” (ASPREE)-AMD trial
2020, Contemporary Clinical Trials CommunicationsCitation Excerpt :Anti-inflammatory property of aspirin could reduce low-grade inflammation in the earlier stages of AMD [9–15], thereby possibly preventing its progression to late AMD, whilst its inhibitory effect on platelet aggregation could exacerbate retinal hemorrhages in late AMD [16–21]. To date the evidence on the effect of aspirin on the course of AMD is mixed, with inconsistent results related to risks and benefits of aspirin in AMD from observational and experimental studies [14–19,21–34] and no definitive conclusions in meta-analyses [20,35–37], which highlighted the need for a well-designed randomized controlled clinical trial of sufficient size and duration [38–42]. The opportunity to conduct such a trial materialized by conducting assessment of the retina status in participants from the major international ASPirin in Reducing Events in the Elderly (ASPREE) clinical trial, which investigated the effect of aspirin on the health of older people.
Submacular hemorrhage with retinal detachment due to an overdose of anticoagulant during age-related macular degeneration
2019, Journal Francais d'Ophtalmologie
∗Supplemental material is available at www.aaojournal.org.
Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article.
Supported by the National Eye Institute, National Institutes of Health, Bethesda, Maryland (cooperative agreement nos.: U10 EY017823, U10 EY017825, U10 EY017826, U10 EY017828, and R21EY023689).
Author Contributions:
Conception and design: Ying, Maguire, Daniel, Grunwald, Martin
Analysis and interpretation: Ying, Maguire, Daniel, Grunwald, Ahmed
Data collection: Ying, Maguire, Daniel, Grunwald, Ahmed, Martin
Obtained funding: Ying, Maguire, Grunwald, Martin
Overall responsibility: Ying, Maguire, Daniel, Grunwald, Ahmed, Martin
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A listing of the Comparison of Age-Related Macular Degeneration Treatments Trials Research Group is available at www.aaojournal.org.