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Warfarin use among wet AMD patients
Author(s) -
Paterno J.J.,
Ahola O.,
Järvikallio R.,
Kiviluoma J.,
Turtiainen H.,
Vuorinen I.,
Kaarniranta K.
Publication year - 2016
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/j.1755-3768.2016.0606
Subject(s) - medicine , warfarin , visual acuity , pro re nata , medical record , macular degeneration , retrospective cohort study , ophthalmology , surgery , atrial fibrillation , ranibizumab , bevacizumab , chemotherapy
Purpose To evaluate the prevalence of warfarin use among wet AMD patients, and impact on clinical outcome. Methods A retrospective analysis of patient records was conducted in Kuopio University Hospital, Finland. We obtained best possible medication history of 414 wet AMD patients and 247 controls, aged 60 years or over, and already excluding other causes of macular oedema by ophthalmologist. Controls were patients with glaucoma or age‐related cataract, with no wet AMD. Due missing medication history, 139 wet AMD patients and 71 controls (p = 0.216) were kept out from the study. When possible, we obtained real‐life 2‐year outcome data of wet AMD treatment for the patient's first eye, solely treated with anti‐VEGF pro re nata . Results The study included 276 wet AMD patients (mean age: 79.5 years) and 175 controls (mean age: 75.3 years). A positive warfarin medication history was detected in 57 (20.7%) wet AMD patients, compared to 16 (9.1%) in control group. Crude OR was 2.59 (95% CI 1.43–4.67, p = 0.001). Age‐adjusted OR was 1.92 (95% CI 1.02–3.60, p = 0.018). Treatment outcome data was obtained from 11 patients (mean age: 77.3 years) using warfarin and 54 patients (mean age: 79.1 years) without warfarin medication. Snellen visual acuity didn't differ between these wet AMD groups at the baseline (0.3 vs. 0.2, p = 0.319). After 2‐year follow‐up, no difference was seen in the change of visual acuity (+0.3 vs. +0.3, p = 0.696), or in number of anti‐VEGF injections (7.8 vs. 9.0, p = 0.435) with respect to the use of warfarin. Conclusions Our study suggest that warfarin use may be more common among wet AMD patients, but it does not have any effect on the outcome of wet AMD treatment. As the study sample is small and wet AMD‐related cardiovascular factors are susceptible to interfere, these initial findings should be verified in a larger prospective study.