title: [Relationship between intravitreal anti-VEGF therapy and subretinal hemorrhage in patients with exudative age-related macular degeneration].
abstract: OBJECTIVE
  To assess and compare frequencies and incidence rates of subretinal hemorrhage (SRH) after intravitreal anti-VEGF injections and spontaneous SRH in patients with exudative age-related macular degeneration (AMD).
  
  
  METHODS
  This retrospective monocentric study included 1079 patients followed for exudative AMD in the ophthalmology department of the university hospital of Dijon from January 2007 to July 2012. For each SRH occuring during this period, the number of previous treatments with intravitreal anti-VEGF was determined, as well as the time between the last injection and the hemorrhage. The SRH was considered as an adverse effect of the anti-VEGF injection if it occurred within 2 months after the last IVT (post-IVT SRH). Frequencies and incidence rates of post-IVT SRH and spontaneous SRH were calculated.
  
  
  RESULTS
  Sixty-six SRH's occurred during the study period with a total frequency of 6.12% (CI95% [4.69-7.55]). Frequencies of spontaneous and post-IVT SRH were respectively 5.65% (CI95% [4.28-7.03]) and 0.46% (CI95% [0.06-0.87]), representing a 12.2 ratio. Post-IVT SRH incidence was 8.3/1000 patient-years (CI95% [1.0-15.5]) and the spontaneous SRH incidence rate was 11.6/1000 patient-years (CI95% [8.3-14.8]), (P=0.472). The incidence rate ratio was 0.72 (CI95% [0.29-1.78]).
  
  
  CONCLUSIONS
  This study did not show a statistically significant change in the incidence of SRH after intravitreal anti-VEGF therapy. The benefit/risk ratio of intravitreal anti-VEGF injections for exudative AMD remains high.
authors.affiliation: Service d'ophtalmologie, hôpital général, CHU de Dijon, 3, rue du Faubourg-Raines, 21000 Dijon, France.
authors.forename: Y
authors.initials: Y
authors.lastname: Kauffmann
authors.affiliation: Service d'ophtalmologie, hôpital général, CHU de Dijon, 3, rue du Faubourg-Raines, 21000 Dijon, France.
authors.forename: R
authors.initials: R
authors.lastname: Isaico
authors.affiliation: Service d'épidémiologie et d'hygiène hospitalière, hôpital général, CHU de Dijon, 3, rue du Faubourg-Raines, 21000 Dijon, France.
authors.forename: A
authors.initials: A
authors.lastname: Lefebvre
authors.affiliation: Service d'ophtalmologie, hôpital général, CHU de Dijon, 3, rue du Faubourg-Raines, 21000 Dijon, France.
authors.forename: A M
authors.initials: AM
authors.lastname: Bron
authors.affiliation: Service d'ophtalmologie, hôpital général, CHU de Dijon, 3, rue du Faubourg-Raines, 21000 Dijon, France. Electronic address: catherine.creuzot-garcher@chu-dijon.fr.
authors.forename: C
authors.initials: C
authors.lastname: Creuzot-Garcher
mesh_terms: D000369:Aged, 80 and over; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage*; D052157:Aptamers, Nucleotide / Q000008:administration & dosage*; D000068258:Bevacizumab; D005260:Female; D006801:Humans; D015994:Incidence; D058449:Intravitreal Injections; D008297:Male; D000069579:Ranibizumab; D012166:Retinal Hemorrhage / Q000139:chemically induced* / Q000453:epidemiology*; D012189:Retrospective Studies; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors*; D057135:Wet Macular Degeneration / Q000188:drug therapy*
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D052157:Aptamers, Nucleotide; D042461:Vascular Endothelial Growth Factor A; C495058:pegaptanib; D000068258:Bevacizumab; D000069579:Ranibizumab
keywords: AMD; Anti-VEGF; DMLA; Hématome sous-rétinien; Incidence; Subretinal hemorrhage
vernacular_title: Relation entre injection intravitréenne d'anti-VEGF et hématome sous-rétinien chez des patients atteints de dégénérescence maculaire liée à l'âge exsudative.