title: Incidence and risk factors for macular hemorrhage following intravitreal ranibizumab injection for neovascular age-related macular degeneration.
abstract: OBJECTIVE
  To analyze the incidence of and risk factors for newly developed or increased macular hemorrhage after intravitreal ranibizumab injection (IVR) for neovascular age-related macular degeneration (AMD).
  
  
  METHODS
  We performed a retrospective chart review of 220 subjects (220 eyes) from 5 hospitals who received IVRs for neovascular AMD between 1 June 2009 and 30 June 2010. Systemic conditions (age, sex, presence of diabetes, hypertension, cardiovascular disease, smoking, and use of anticoagulation agent) and presence of hemorrhage at the initial exam were evaluated. The primary study outcome was the incidence of newly developed or increased macular hemorrhage during the 1-month postinjection period.
  
  
  RESULTS
  The incidence of newly developed or increased macular hemorrhage including vitreous hemorrhage was 8% (18/220). Presence of diabetes was found to be a risk factor for macular hemorrhage [odds ratios (OR): 2.16, 95% confidence intervals (CI): 1.07-8.13]. When subjects had both diabetes and hypertension, the risk of macular hemorrhage after injection increased 4.8-fold (OR: 4.84, CI: 1.24-18.85).
  
  
  CONCLUSIONS
  The systemic condition of subjects was found to be an important risk factor for newly developed or increased macular hemorrhage after IVR for neovascular AMD. More consideration should be given to the status of diabetes and hypertension in subjects who receive ranibizumab for neovascular AMD.
authors.affiliation: Department of Ophthalmology, Kyung Hee University School of Medicine, Seoul, Korea.
authors.forename: Sang Woong
authors.initials: SW
authors.lastname: Moon
authors.forename: Jaeryung
authors.initials: J
authors.lastname: Oh
authors.forename: Hyeong Gon
authors.initials: HG
authors.lastname: Yu
authors.forename: Hee Yoon
authors.initials: HY
authors.lastname: Cho
authors.forename: Su Jeong
authors.initials: SJ
authors.lastname: Song
mesh_terms: D000368:Aged; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D005130:Eye Hemorrhage / Q000139:chemically induced / Q000453:epidemiology / Q000209:etiology; D005260:Female; D006801:Humans; D015994:Incidence; D058449:Intravitreal Injections; D008268:Macular Degeneration / Q000150:complications / Q000188:drug therapy*; D008297:Male; D008499:Medical Records; D000069579:Ranibizumab; D015861:Retinal Neovascularization / Q000150:complications / Q000188:drug therapy*; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; D000069579:Ranibizumab