Incidence of retinal vein occlusions (RVO) in patients treated with oral anticoagulants or antiplatelet drugs for cardioembolic or atherothrombotic prevention

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PurposeIt is still a matter of debate whether anticoagulant or antiplatelet therapy are useful for the prevention of retinal vein occlusions. In some cases, patients who are already under antiplatelet or anticoagulant therapy still develop retinal venous diseases. We analyzed the prevalence of RVO in patients treated yet with warfarin or aspirin for other clinical indications.Methods64 patients (30 CRVO and 34 BRVO) treated with warfarin for atrial fibrillation (n = 11) or aspirin for carotid stenosis (n = 53) were observed. Multivariate analysis was employed to detect any putative relation among treatments and CRVO or BRVO.ResultsThe whole cohort analysis showed that aspirin was less effective than warfarin for prevention of RVO (H.R. 2.4, 95% C.I. 1.9–3.2 p < 0.01); 9 BRVO and 2 CRVO were in patients treated with warfarin whereas 25 BRVO and 28 CRVO in aspirin treated subjects. The confirmation test showed an H.R. of 2.1 (1.6–3.1 95% C.I.) p < 0.01, for the association between aspirin treatment and CRVO.ConclusionsSuch retrospective data indicate that aspirin could be less effective in RVO and particularly CRVO prevention with respect to anticoagulants. Planned large prospective observational studies are needed to study the efficacy of such treatments in RVO prevention and treatment. Our data could fit well with the previous observation that specific pro‐coagulative state as suggested by increased thrombin generation is a pattern of CRVO with respect to BRVO.