title: INTRAVITREAL RANIBIZUMAB THERAPY FOR NEOVASCULAR AGE-RELATED MACULAR DEGENERATION AND THE RISK OF STROKE: A National Sample Cohort Study.
abstract: OBJECTIVE
  To evaluate the risk of stroke after ranibizumab treatment for neovascular age-related macular degeneration.
  
  
  METHODS
  National registry data for 1,025,340 random subjects in the year 2002 were used. The ranibizumab group comprised patients diagnosed with neovascular age-related macular degeneration and treated with ranibizumab between 2009 and 2013 (n = 467). The two types of comparison groups were defined as comorbidity-matched controls (n = 2,330) comprised of randomly selected patients (5 per age-related macular degeneration patient), who were matched to the ranibizumab group according to sociodemographic factors, hypertension, atrial fibrillation, and the Charlson comorbidities index, and sociodemographic-matched controls (n = 2,331) matched according to sociodemographic factors only. Each sampled patient was tracked until 2013. The Cox proportional hazard regression was used.
  
  
  RESULTS
  Stroke occurred in 6.6% of the ranibizumab group versus 7.0% of the comorbidity-matched controls and 6.7% of the sociodemographic-matched controls; these differences were not statistically significant. The overall incidence of stroke was similar for the ranibizumab group versus the comorbidity-matched controls and sociodemographic-matched controls, based on the multivariable Cox regression (hazard ratio = 0.88; 95% confidence interval, 0.60-1.30; hazard ratio = 0.95, 95% confidence interval, 0.64-1.41, respectively).
  
  
  CONCLUSIONS
  Ranibizumab treatment for neovascular age-related macular degeneration did not increase the overall risk of stroke, compared with comorbidity-matched controls or sociodemographic-matched controls.
authors.affiliation: *Department of Ophthalmology, National Health Insurance Service Ilsan Hospital; †Department of Ophthalmology, Severance Hospital, Institute of Vision Research, Yonsei University College of Medicine, Seoul, Republic of Korea; ‡Yonsei Healthcare Big Data Based Knowledge Integration System Research Center, Yonsei University College of Medicine, Seoul, Republic of Korea; and §Institute of Convergence Science, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Tyler Hyungtaek
authors.initials: TH
authors.lastname: Rim
authors.forename: Christopher Seungkyu
authors.initials: CS
authors.lastname: Lee
authors.forename: Sung Chul
authors.initials: SC
authors.lastname: Lee
authors.forename: Do Wook
authors.initials: DW
authors.lastname: Kim
authors.forename: Sung Soo
authors.initials: SS
authors.lastname: Kim
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D020256:Choroidal Neovascularization / Q000188:drug therapy*; D015331:Cohort Studies; D016208:Databases, Factual; D005260:Female; D006801:Humans; D015994:Incidence; D058449:Intravitreal Injections; D008297:Male; D008875:Middle Aged; D000069579:Ranibizumab / Q000627:therapeutic use*; D056910:Republic of Korea / Q000453:epidemiology; D012307:Risk Factors; D020521:Stroke / Q000453:epidemiology*; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors; D014792:Visual Acuity; D057135:Wet Macular Degeneration / Q000188:drug therapy*
chemical_list: D020533:Angiogenesis Inhibitors; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D000069579:Ranibizumab