Anticoagulation Therapy and Influence on Retinal Vein Occlusion and Intraocular Bleeding Risk Across a Large US National Database.

BACKGROUND AND

OBJECTIVE

Management of hypercoagulable states with systemic anticoagulation is standard of care. The risk of future retinal vein occlusion (RVO) development with direct oral anticoagulation agents (DOACs) has yet to be investigated in a large United States cohort.

PATIENTS AND

METHODS

Retrospective cohort study using a large ICD-10 coded database. The database was queried for patients being managed with warfarin or DOACs. Propensity score matching was then used to create comparable groups. Risk ratios for RVO and intraocular bleed development in patients without a prior diagnosis of RVO were calculated.

RESULTS

Patients managed with warfarin were found to be at significantly increased risk of developing a new diagnosis of all RVO (risk ratio [RR]: 1.49, 1.42-1.57), vitreous hemorrhage (RR: 2.14, 1.98-2.30), retinal hemorrhage (RR: 1.84, 1.71-1.97) and choroidal hemorrhage (RR: 2.06, 1.53-2.79), compared to patients managed with DOACs.

CONCLUSION

These findings suggest DOACs are associated with significantly reduced retinal vein occlusion and intraocular bleeding risk compared to warfarin.