Taipei, Taiwan: Antiplatelet/anticoagulant (APAC) medications have a protective effect against the development of nonproliferative diabetic retinopathy (NPDR) in type 2 diabetes patients, a recent study has found. The authors wrote, "single-use of aspirin or dipyridamole may benefit diabetes patients for the prevention of nonproliferative diabetic retinopathy." The study appears in the journal BMC Ophthalmology.

Cheng-Li Lin, Management Office for Health Data, China Medical University, Taichung, Taiwan, and colleagues conducted the study with an aim to investigate whether antiplatelet/anticoagulant therapy can protect patients with type 2 diabetes mellitus from the development or progression of diabetic retinopathy (DR) in a retrospective cohort study.
The study used Longitudinal Health Insurance Database in Taiwan. It included a total of 73,964 patients with type 2 diabetes older than 20 years old. Hazard ration (HR) of non-proliferative DR (NPDR), proliferative DR (PDR), and diabetic macular edema (DME) were analyzed with APAC usage as a time-dependent covariate. In a multivariable model, age sex, comorbidities, and medicines were further adjusted. Contributions of respective APAC were investigated with sensitivity analysis.
The study found the following:
· Compared with nonusers, APAC users had a lower cumulative incidence of NPDR, the overall incidence of NPDR (10.7 per 1000 person-years), and the risk of developing NPDR (adjusted HR = 0.78).
· No significant differences were observed between APAC users and nonusers in the risks of PDR or DME.
· Hypertension, diabetic nephropathy, and diabetic neuropathy were risk factors for NDPR development, while heart disease, cardiovascular disease, peripheral arterial occlusive disease, and statin usage were covariates decreasing NPDR development.
· Aspirin and Dipyridamole showed significant protection against NPDR development.
· Clopidogrel, Ticlopidine, and warfarin showed enhanced protection in combination with aspirin usage.
"APAC medications have a protective effect against the development of NPDR," wrote the authors. "Diabetes patients benefit from single-use of aspirin or dipyridamole on the prevention of NPDR."
Reference:
Jeng, CJ., Hsieh, YT., Lin, CL. et al. Effect of anticoagulant/antiplatelet therapy on the development and progression of diabetic retinopathy. BMC Ophthalmol 22, 127 (2022). https://doi.org/10.1186/s12886-022-02323-z