title: Antithrombotic medication and incident open-angle glaucoma.
abstract: OBJECTIVE
  To determine the associations between the use of antithrombotic drugs and incident open-angle glaucoma (OAG).
  
  
  METHODS
  Ophthalmic examinations including measurements of the IOP and perimetry were performed at baseline and follow-up in 3939 participants of the prospective population-based Rotterdam Study who did not have OAG at baseline. The use of antithrombotic drugs was monitored continuously during follow-up. Antithrombotic drugs were stratified into anticoagulants and platelet aggregation inhibitors. Associations between incident OAG and the use of antithrombotic drugs were assessed using Cox regression; the model was adjusted for age, sex, baseline IOP and IOP-lowering treatment, family history of glaucoma, and myopia. Associations between antithrombotic drugs and IOP at follow-up were analyzed with multiple linear regression.
  
  
  RESULTS
  During a mean follow-up of 9.8 years, 108 participants (2.7%) developed OAG. The hazard ratio for anticoagulant use was 0.90 (95% confidence interval [CI], 0.55-1.48; P = 0.69) and for platelet aggregation inhibitors 0.80 (0.53-1.21; P = 0.28). There was no trend towards a reduced or increased risk of incident OAG with prolonged anticoagulant use (P value for trend 0.84) or platelet aggregation inhibitor use (0.59). There was a significant IOP-lowering effect of anticoagulants (-0.31 mm Hg; 95% CI, -0.58 to -0.04 mm Hg; P = 0.025) but not of platelet aggregation inhibitors (P = 0.06). The IOP-lowering effect of anticoagulants disappeared after additional adjustment for the use of systemic beta-blockers.
  
  
  CONCLUSIONS
  Use of anticoagulants or platelet aggregation inhibitors appears not to be associated with incident OAG.
authors.affiliation: Department of Ophthalmology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
authors.forename: Michael W
authors.initials: MW
authors.lastname: Marcus
authors.forename: Rogier P H M
authors.initials: RP
authors.lastname: Müskens
authors.forename: Wishal D
authors.initials: WD
authors.lastname: Ramdas
authors.forename: Roger C W
authors.initials: RC
authors.lastname: Wolfs
authors.forename: Paulus T V M
authors.initials: PT
authors.lastname: de Jong
authors.forename: Johannes R
authors.initials: JR
authors.lastname: Vingerling
authors.forename: Albert
authors.initials: A
authors.lastname: Hofman
authors.forename: Bruno H C
authors.initials: BH
authors.lastname: Stricker
authors.forename: Nomdo M
authors.initials: NM
authors.lastname: Jansonius
mesh_terms: D000368:Aged; D000925:Anticoagulants / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D005902:Glaucoma, Open-Angle / Q000139:chemically induced* / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D007429:Intraocular Pressure / Q000187:drug effects*; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects*; D011446:Prospective Studies; D012307:Risk Factors; D058609:Visual Field Tests
chemical_list: D000925:Anticoagulants; D010975:Platelet Aggregation Inhibitors