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목적 : The effects of non-vitamin K oral anticoagulant (NOAC) on macrovascular diseases such as stroke prevention have been reported, while the efficacy issue on microvascular conditions including retinal vascular occlusion needs to be evaluated. We investigated the frequency of retinal vascular occlusions in patients undergoing anticoagulant therapy, comparing the risk associated with NOAC and warfarin.
방법 : The medical records of 528 patients with anticoagulant therapy whose ocular findings were verified at Ophthalmology department from January 2010 to September 2018 were retrospectively reviewed. Propensity score matching on a 1:1 ratio were performed based on age and systemic comorbid conditions.
결과 : Eight of 154 patients (5.2%) treated with NOAC and 23 of 374 (6.1%) treated with warfarin presented with retinal vascular occlusions during the study period. Treatment with NOAC reduced the risk of retinal vascular occlusion, but this was not statistically significant both before (odd ratio (OR) 0.836, 95% confidence interval (CI) 0.366-1.913, P = 0.672) and after propensity score matching (OR 0.79, 95% CI 0.30-2.056, P = 0.628). Treatment with NOAC reduced also the risk of secondary intraocular bleeding, without statistical significance (OR 0.265, 95% CI 0.033-2.110, P = 0.210).
결론 : Treatment with NOAC did not increase the risk of retinal vascular occlusions compared to warfarin. Studies with larger number of patients are needed to confirm the effect of NOAC on microvascular complications including retinal vascular occlusions.
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