Relationship between anticoagulant medication and massive intraocular hemorrhage in age-related macular degeneration

Background: A massive intraocular hemorrhage in the course of age-related m acular degeneration (AMD) is a devastating event. We set out to determine t he role of anticoagulant therapy prescribed for vascular or cardiac indicat ions 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 vit reous 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 d ifference in the use of antiplatelet medication (aspirin) between the group s 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 all owed to stop the anticoagulant medication. Conclusion: Anticoagulant medication poses a significant risk in the develo pment of a massive intraocular hemorrhage in patients with exudative AMD. A ntiplatelet medication poses a less significant risk. Physicians prescribin g anticoagulant medication should be informed about the macular status of t he patient. the In case of neovascular AMD, anticoagulant medication should be prescribed only for absolute systemic indications.