Relationship between anticoagulant medication and massive intraocular hemorrhage in age-related macular degeneration.
BACKGROUND
A massive intraocular hemorrhage in the course of age-related macular degeneration (AMD) is a devastating event. We set out to determine the role of anticoagulant therapy prescribed for vascular or cardiac indications in the development of a massive hemorrhage.


METHODS
A retrospective case-controlled study was conducted of 50 cases of age-related macular degeneration complicated by massive subretinal and vitreous hemorrhage. The control group consisted of 50 cases of AMD with small subretinal hemorrhage.


RESULTS
There was a significant difference in the use of anticoagulant medication (warfarin sodium) between the groups. The difference in the use of antiplatelet medication (aspirin) between the groups was not significant. A patient with a massive intraocular hemorrhage and AMD is 11.6 times more likely to use anticoagulant medication. It appeared that more than 50% of the patients in the massive hemorrhage group were allowed to stop the anticoagulant medication.


CONCLUSIONS
Anticoagulant medication poses a significant risk in the development of a massive intraocular hemorrhage in patients with exudative AMD. Antiplatelet medication poses a less significant risk. Physicians prescribing anticoagulant medication should be informed about the macular status of the patient. the In case of neovascular AMD, anticoagulant medication should be prescribed only for absolute systemic indications.
Tilanus
M A
MA
Institute of Ophthalmology, University Hospital Nijmegen, The Netherlands. m.tilanus@ohk.azn.nl
Vaandrager
W
W
Cuypers
M H
MH
Verbeek
A M
AM
Hoyng
C B
CB
D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000009:adverse effects*; D001241:Aspirin / Q000009:adverse effects; D011307:Drug Prescriptions; D005130:Eye Hemorrhage / Q000139:chemically induced* / Q000000981:diagnostic imaging / Q000473:pathology; D005260:Female; D006801:Humans; D008268:Macular Degeneration / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects; D012189:Retrospective Studies; D012307:Risk Factors; D014463:Ultrasonography; D014792:Visual Acuity; D014823:Vitreous Hemorrhage / Q000139:chemically induced / Q000000981:diagnostic imaging / Q000473:pathology; D014859:Warfarin / Q000009:adverse effects
D000925:Anticoagulants; D010975:Platelet Aggregation Inhibitors; D014859:Warfarin; D001241:Aspirin