Association between systemic anticoagulation and rate of intraocular hemorrhage following intravitreal anti-VEGF therapy for age-related macular degeneration.

BACKGROUND AND OBJECTIVE

To investigate the association between systemic anticoagulant medication usage at the time of intravitreal anti-vascular endothelial growth factor (anti-VEGF) injection with post-injection intraocular hemorrhage among patients with age-related macular degeneration (AMD).

PATIENTS AND METHODS

Retrospective, consecutive case series of all patients treated with anti-VEGF injection for neovascular AMD at the Penn State Hershey Eye Center between 2004 and 2010: 1,710 anti-VEGF injections performed in 228 eyes of 191 patients. Each injection was analyzed according to whether the patient was taking systemic anticoagulant medication at the time of injection.

RESULTS

Intraocular hemorrhage occurred after intravitreal anti-VEGF injection in four eyes (0.25%). Vitreous hemorrhage occurred in three patients taking systemic anticoagulation. Subretinal hemorrhage occurred in one patient not on anticoagulant therapy. In a bivariate analysis, the odds of intraocular hemorrhage are 1.9 times higher for injections performed in patients on systemic anticoagulation versus those not on systemic anticoagulation; this difference is not statistically significant.

CONCLUSION

The rate of intraocular hemorrhage after intravitreal injection of anti-VEGF therapy among patients with AMD is low, and there is no significant difference between patients taking systemic anticoagulant medications at the time of injection and patients not on anticoagulation.