Dalteparin in the management of recent onset central retinal vein occlusion: a comparison with acetylsalicylic acid

Background: The present study assessed the therapeutic effects of dalteparin in patients who had recent onset central retinal vein occlusion (CRVO) as compared with those of acetylsalicylic acid (ASA). Methods: Patients with recent onset of CRVO were randomly assigned to receive dalteparin subcutaneously every day for 20 days or ASA daily for the same period. Complete ophthalmic examinations were conducted at baseline and at each follow-up interval: I week and I, 2, 3, 4, and 6 months later. Best-corrected visual acuity was assessed by an investigator blind to the treatment group. Results: The mean 6-month change in logMAR visual acuity for dalteparin-treated patients was an increase of 5.5 letters (Early Treatment Diabetic Retinopathy Study chart) (-0.11 [SD 0.71] logMAR) and for ASA-treated patients was a decrease of 14 letters (+0.28 [SD 0.79] logMAR), representing a significant difference between the 2 groups (p = 0.016). One patient in the dalteparin group and 14 in the ASA group showed iris neovascularization (NVI) (2.1% vs. 30.4%, p = 0.0001). Interpretation: Dalteparin was found to be superior to ASA in terms of improving visual acuity and preventing NVI over the first 6 months of treatment. Similar studies are recommended of other newer types of anticoagulants, especially those that could be used orally.