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

Graefes Arch Clin Exp Ophthalmol. 2000 Jun;238(6):482-5. doi: 10.1007/pl00007887.


Background: A massive intraocular hemorrhage in the course of age-related macular degeneration (AMD) is a devastating event. We set out to determine the role of anticoagulant therapy prescribed for vascular or cardiac indications 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 vitreous 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 difference in the use of antiplatelet medication (aspirin) between the groups 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 allowed to stop the anticoagulant medication.

Conclusion: Anticoagulant medication poses a significant risk in the development of a massive intraocular hemorrhage in patients with exudative AMD. Antiplatelet medication poses a less significant risk. Physicians prescribing anticoagulant medication should be informed about the macular status of the patient. the In case of neovascular AMD, anticoagulant medication should be prescribed only for absolute systemic indications.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Anticoagulants / adverse effects*
  • Aspirin / adverse effects
  • Drug Prescriptions
  • Eye Hemorrhage / chemically induced*
  • Eye Hemorrhage / diagnostic imaging
  • Eye Hemorrhage / pathology
  • Female
  • Humans
  • Macular Degeneration / diagnostic imaging
  • Macular Degeneration / drug therapy*
  • Macular Degeneration / pathology
  • Male
  • Middle Aged
  • Odds Ratio
  • Platelet Aggregation Inhibitors / adverse effects
  • Retrospective Studies
  • Risk Factors
  • Ultrasonography
  • Visual Acuity
  • Vitreous Hemorrhage / chemically induced
  • Vitreous Hemorrhage / diagnostic imaging
  • Vitreous Hemorrhage / pathology
  • Warfarin / adverse effects


  • Anticoagulants
  • Platelet Aggregation Inhibitors
  • Warfarin
  • Aspirin