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Multicenter Study
. 2018 Nov;38(11):2247-2252.
doi: 10.1097/IAE.0000000000001869.

TESTOSTERONE SUPPLEMENTATION AND RETINAL VASCULAR DISEASE

Affiliations
Multicenter Study

TESTOSTERONE SUPPLEMENTATION AND RETINAL VASCULAR DISEASE

Vaidehi S Dedania et al. Retina. 2018 Nov.

Abstract

Purpose: To determine whether testosterone supplementation is associated with retinal artery occlusion (RAO) or retinal vein occlusion (RVO).

Methods: Retrospective matched cohort study using data from a large national U.S. insurance database. The testosterone cohort consisted of all male patients who filled a prescription for testosterone from 2000 to 2013. Five controls were matched on age (±3 years), sex, race, and similar time in plan (±3 months) for every exposed patient. Exclusion occurred for <2 years in the plan, <1 eye care visit, medications known to affect androgen levels, and systemic diseases associated with occlusions or increased testosterone. Cox proportional hazard regression assessed the hazard of a new diagnosis of RAO or RVO while controlling for age, race, diabetes mellitus, and hypertension.

Results: A total of 35,784 incident testosterone users were compared with 178,860 matched controls. Ninety-three (0.3%) RAOs and 50 (0.1%) RVOs were found in the testosterone cohort and contrasted with 316 (0.2%) RAOs and 232 (0.1%) RVOs in the control group. After multivariate analysis, testosterone supplementation significantly increased the hazard of RAO (hazard ratio: 1.43, 95% confidence interval: 1.12-1.81, P = 0.004), but not of RVO (hazard ratio: 1.03, 95% confidence interval: 0.74-1.42, P = 0.86).

Conclusion: Although the incidence of RAO and RVO is low in users of testosterone, supplementation therapy is associated with an increased hazard of RAO, but apparently not of RVO.

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Conflict of interest statement

Conflicts Of Interest: None

Figures

Figure 1
Figure 1
Flowchart demonstrating the patients excluded for each criteria and the final exposed cohort in the study.

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