title: Poor outcomes despite aspirin or statin use in high-risk patients with retinal vein occlusion.
abstract: OBJECTIVE
  Since atherosclerosis contributes to the pathophysiology of retinal vein occlusion (RVO), we aimed to assess the effects of aspirin and statins on the visual outcomes of RVO in high-risk patients, whom we define to have hypertension and open-angle glaucoma prior to RVO.
  
  
  METHODS
  We conducted a retrospective case-control study of adults diagnosed with RVO between 2006 and 2014. To evaluate for a preventive effect of these medications, we compared the prevalence of aspirin or statin use (either separately or concomitantly) among high-risk patients who developed RVO and among those who did not during at least 2 years of follow-up. To evaluate for a therapeutic effect, we then compared the final follow-up visual acuity (VA) of high-risk RVO patients who had and who had not been taking a statin prior to the RVO.
  
  
  RESULTS
  We analyzed 43 eyes [23 central RVOs (CRVOs), 16 branch RVOs (BRVOs), and 4 hemi-RVOs (HRVOs)] from 42 high-risk patients, along with 129 high-risk controls. There was no significant difference (p = 0.47) in aspirin exposure between the control (60%) and RVO (67%) groups, and the increased statin exposure among controls (72% vs. 53% for the cases; p = 0.03) paralleled their higher prevalence of hyperlipidemia. The non-statin and statin RVO groups each had a mean VA of 20/800 at a mean 30 and 43 months of follow-up, respectively.
  
  
  CONCLUSIONS
  No preventive benefit of aspirin or statins, and no therapeutic benefit of statins, was found for RVO in high-risk patients. High-risk RVO patients suffer substantially worse outcomes than those reported in other studies not limited to such patients.
authors.affiliation: Department of Ophthalmology, University of Texas Southwestern Medical Center at Dallas, 5323 Harry Hines Blvd., Dallas, TX, 75390-9057, USA. vlad.matei@phhs.org.
authors.forename: Vlad M
authors.initials: VM
authors.lastname: Matei
authors.affiliation: Department of Ophthalmology, University of Texas Southwestern Medical Center at Dallas, 5323 Harry Hines Blvd., Dallas, TX, 75390-9057, USA.
authors.forename: Jonathan Y
authors.initials: JY
authors.lastname: Xia
authors.affiliation: Department of Ophthalmology, University of Texas Southwestern Medical Center at Dallas, 5323 Harry Hines Blvd., Dallas, TX, 75390-9057, USA.
authors.forename: Chan
authors.initials: C
authors.lastname: Nguyen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001241:Aspirin / Q000008:administration & dosage*; D050197:Atherosclerosis / Q000150:complications / Q000453:epidemiology / Q000517:prevention & control*; D016022:Case-Control Studies; D004305:Dose-Response Relationship, Drug; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage; D015995:Prevalence; D012170:Retinal Vein Occlusion / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology; D014792:Visual Acuity
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D010975:Platelet Aggregation Inhibitors; D001241:Aspirin
keywords: Branch retinal vein occlusion; Central retinal vein occlusion; Open-angle glaucoma; Pharmacotherapy; Visual outcomes