Efficacy and safety of non-vitamin K-antagonist oral anticoagulants for retinal vascular diseases in patients with atrial fibrillation: Korean cohort study

Park, Se-Jun; Lee, Eun-Young; Lee, Kihwang; Park, Bumhee; Chung, Yoo‐Sam

doi:10.1038/s41598-020-61609-8

Cited by 3 publications

(2 citation statements)

References 36 publications

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“…However, these do not appear to be discussed in this study . Park et al found a higher hazard ratio for RVO but not for RAO with direct-acting oral anticoagulants. Diuretics will increase the plasma osmolality and induce prothrombotic status subsequently, and oral contraceptives are a well known factor of increasing the incidence of venous thromboembolism.…”

contrasting

confidence: 65%

Correspondence Regarding Changes in the Incidence of Retinal Vascular Occlusions After COVID-19 Diagnosis

Lin

Wei

2022

JAMA Ophthalmol

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topic 2 supporting these meta-analytic results (we observed lower diabetic retinopathy [DR] prevalence in pregnant women with T2D than those with type 1 diabetes [T1D]).We agree that our included studies had small sample sizes and this condition has been reported to cause bias. 3 Especially for studies with 0 events, we understand that continuity corrections in meta-analyses can be problematic, as mentioned by Zhou and Shen and the literature. 3,4 However, we avoided a need for continuity correction to stabilize variances in our meta-analyses by choosing to use the Freeman-Tukey double-arcsine transformation (FTT) method for our random-effects model. 4 We ran an additional generalized linear mixed model (GLMM), specifically, a random intercept mixed-effects logistic regression model to confirm and compare with our pooled estimates from the FTT method. In all but 1 outcome (progression from nonproliferative diabetic retinopathy to proliferative diabetic retinopathy), the 2 methods were comparable (eTable 8 in the Supplement). 1 Although we note that a GLMM method would remove much of the concern around sampling error and bias, one downside to the GLMM is a lack of transparency regarding the weights given to each study. Thus, we decided to present the FTT results and forest plots so that our readers can focus on the clinical message and not be distracted by methodological arguments. In that vein, while prediction intervals can provide a useful concept for interpreting published pooled estimates of effect size of one treatment compared with another in the context of clinical decision-making for an individual patient, 5 we omitted them because if a clinician wanted to predict their presentday patients' risk of developing DR or predict its progression in pregnancy, they may be better served to consider only studies with excellent quality, validated DR grading schemes, and consistent methodology in a population with the same type of diabetes and access to the same level of (present day) diabetes care. Using such criteria, this would limit the analysis to only 4 T1D studies (grand total of 82 participants). We plan to produce a table of meta-analysis results from FTT and GLMM methods that include prediction intervals and look forward to the opportunity to present these results.

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confidence: 65%

Correspondence Regarding Changes in the Incidence of Retinal Vascular Occlusions After COVID-19 Diagnosis

Lin

Wei

2022

JAMA Ophthalmol

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“…They concluded that only edoxaban was associated with a significantly diminished risk of intraocular bleeding compared with warfarin. Moreover, a prospective cohort study conducted by Campello et al ( 15 ), enrolling 275 cases and 322 controls, found that there was a slightly increased incidence of bleeding in thrombophilia patients treated with NOACs. Subsequently, a large observational cohort study by Park et al ( 16 ) enrolled 27,496 patients with warfarin and 93,691 NOAC users and concluded that the risk of intraocular bleeding was lower in the NOAC group.…”

Section: Introductionmentioning

confidence: 99%

Intraocular Bleeding in Patients With Atrial Fibrillation Treated With NOACs VS. Warfarin: A Systematic Review and Meta-Analysis

Liu

Zhang

Luo

et al. 2022

Front. Cardiovasc. Med.

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BackgroundIntraocular bleeding is a devastating adverse event for patients with atrial fibrillation (AF) receiving anticoagulant therapy. It is unknown whether non-vitamin K oral anticoagulants (NOACs) compared with warfarin can reduce the risk of intraocular bleeding in patients with AF. Herein, we conducted a meta-analysis to evaluate the effect of NOACs vs. warfarin on intraocular bleeding in the AF population.MethodsStudies were systematically searched from the Embase, PubMed, and Cochrane databases until April 2022. We included studies if they enrolled patients with AF and compared the intraocular bleeding risk between NOACs and warfarin and if they were randomized controlled trials (RCTs) or observational cohort studies. The random-effects model was chosen to evaluate the pooled odds ratios (ORs) and 95% confidence intervals (CIs).ResultsA total of 193,980 patients with AF from 5 randomized controlled trials (RCTs) and 1 cohort study were included. The incidence of intraocular bleeding among AF patients treated with warfarin and NOACs was 0.87% (n = 501/57346) and 0.61% (n = 836/136634), respectively. In the pooled analysis with the random-effects model, the use of NOACs was not significantly associated with the risk of intraocular bleeding (OR = 0.74; 95% CI 0.52–1.04, P = 0.08) compared with warfarin use. In addition, the sensitivity analysis with the fixed-effects model suggested that NOAC users had a lower incidence of intraocular bleeding than patients with warfarin (OR = 0.57; 95% CI 0.51–0.63, P < 0.00001).ConclusionsOur current meta-analysis suggested that the use of NOACs had no increase in the incidence of intraocular bleeding compared with warfarin use in patients with AF. Whether the use of NOACs is superior to warfarin needs more research to confirm.

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Retinal Vein Occlusion–Background Knowledge and Foreground Knowledge Prospects—A Review

Lendzioszek,

Bryl,

Poppe

et al. 2024

JCM

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Thrombosis of retinal veins is one of the most common retinal vascular diseases that may lead to vascular blindness. The latest epidemiological data leave no illusions that the burden on the healthcare system, as impacted by patients with this diagnosis, will increase worldwide. This obliges scientists to search for new therapeutic and diagnostic options. In the 21st century, there has been tremendous progress in retinal imaging techniques, which has facilitated a better understanding of the mechanisms related to the development of retinal vein occlusion (RVO) and its complications, and consequently has enabled the introduction of new treatment methods. Moreover, artificial intelligence (AI) is likely to assist in selecting the best treatment option for patients in the near future. The aim of this comprehensive review is to re-evaluate the old but still relevant data on the RVO and confront them with new studies. The paper will provide a detailed overview of diagnosis, current treatment, prevention, and future therapeutic possibilities regarding RVO, as well as clarifying the mechanism of macular edema in this disease entity.

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Efficacy and safety of non-vitamin K-antagonist oral anticoagulants for retinal vascular diseases in patients with atrial fibrillation: Korean cohort study

Cited by 3 publications

References 36 publications

Correspondence Regarding Changes in the Incidence of Retinal Vascular Occlusions After COVID-19 Diagnosis

Correspondence Regarding Changes in the Incidence of Retinal Vascular Occlusions After COVID-19 Diagnosis

Intraocular Bleeding in Patients With Atrial Fibrillation Treated With NOACs VS. Warfarin: A Systematic Review and Meta-Analysis

Retinal Vein Occlusion–Background Knowledge and Foreground Knowledge Prospects—A Review

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