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Yong-Il Shin, Jae-Yun Sung, Jung-Yeul Kim; Risk factors for breakthrough vitreous hemorrhage after intravitreal anti-VEGF injection in age-related macular degeneration. Invest. Ophthalmol. Vis. Sci. 2018;59(9):812.
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To investigate the risk factors for breakthrough vitreous hemorrhage (VH) after intravitreal anti-vascular endothelial growth factor (anti-VEGF) injection in age-related macular degeneration (AMD) with submacular hemorrhage.
We retrospectively reviewed the medical records of patients diagnosed as AMD with submacular hemorrhage from January 2008 to January 2017. 29 patients with breakthrough VH after intravitreal anti-VEGF injection in AMD with submacular hemorrhage were enrolled. An age- and sex-matched control group patients were obtained who did not developed breakthrough VH after intravitreal anti-VEGF injection. We compared past medical history, anticoagulant medication, visual acuity, subtype of AMD, type of anti VEGF-agent, and size of submacular hemorrhage to identify possible risk factors between two groups.
The mean age was 70.4 ± 10.9 years in breakthrough VH group. In 29 patients, 6 patients were diagnosed as choroidal neovascularization(CNV), 22 patients were diagnosed as polypoidal choroidal vasculopathy(PCV) and 1 patients were diagnosed as retinal angiomatous proliferation(RAP). PCV was associated with a significantly higher incidence of VH (odds ratio, 14.91; p=0.001). The size of submacular hemorrhage was 23.69 ± 12.19 disc area (DA) in breakthrough VH group and 5.45 ± 6.93 DA in control group. The size of submacular hemorrhage was significantly positively related to the occurrence of VH (p<0.001). The risk of vitreous hemorrhage was significantly higher when anticoagulants were administered (p=0.004). There were no significant difference between the type of anti-VEGF agent.
Taking anticoagulant medication, large-diameter submacular hemorrhage and PCV subtype were risk factors for breakthrough VH after anti-VEGF injection
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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