Massive choroidal hemorrhage in age-related macular degeneration: a complication of anticoagulant therapy.
BACKGROUND
Age-related macular degeneration (ARMD) is the leading cause of legal blindness in the elderly, causing profound loss of central vision.


METHODS
A 90-year-old patient with exudative age-related macular degeneration who had been placed on anticoagulant therapy for pulmonary emboli experienced a massive choroidal hemorrhage and retinal detachment. Angle closure glaucoma was precipitated by forward movement of the iris-lens diaphragm and vision was lost in the eye. The patient was subsequently removed from anticoagulant therapy, although he had potentially fatal bilateral pulmonary emboli, because of the patient's concern for the quality of his remaining life.


RESULTS
This case report is intended to alert optometrists to the ocular complications of anticoagulant therapy, particularly the risk of massive choroidal hemorrhage in anticoagulated patients with exudative ARMD.


CONCLUSIONS
An optometrist's responsibility to inform primary care providers of the potential ocular complications of anticoagulant therapy for patients with exudative ARMD is also described.
DVA Outpatient Clinic, Oakland, CA 94612, USA.
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Edwards
D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000009:adverse effects* / Q000627:therapeutic use; D002832:Choroid Hemorrhage / Q000139:chemically induced*; D005654:Fundus Oculi; D015812:Glaucoma, Angle-Closure / Q000209:etiology; D006801:Humans; D008268:Macular Degeneration / Q000150:complications*; D008297:Male; D011655:Pulmonary Embolism / Q000150:complications / Q000188:drug therapy; D012163:Retinal Detachment / Q000139:chemically induced; D014859:Warfarin / Q000009:adverse effects* / Q000627:therapeutic use
D000925:Anticoagulants; D014859:Warfarin