Key result
Warfarin was associated with a increased risk of developing a new diagnosis of retinal vein occlusion compared to DOACs.
Why the study?
The risk of future retinal vein occlusion development with DOACs had not yet been investigated in a large United States cohort.
Do DOACs reduce the risk of retinal vein occlusion and intraocular bleeding compared to warfarin in patients requiring systemic anticoagulation?
Cohort
Yes
Do DOACs reduce the risk of retinal vein occlusion and intraocular bleeding compared to warfarin in patients requiring systemic anticoagulation?
Answers are grounded in this paper and cite their sources.
In a large US cohort, DOACs were associated with a significantly lower risk of developing retinal vein occlusion and intraocular bleeding compared to warfarin.
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.
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Russell et al. (2025) conducted a cohort in Hypercoagulable states. Warfarin vs. DOACs was evaluated on New diagnosis of all retinal vein occlusion (RVO) (RR 1.49, 95% CI 1.42-1.57). Warfarin was associated with a increased risk of developing a new diagnosis of retinal vein occlusion compared to DOACs.
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