Association of rivaroxaban anticoagulation and spontaneous vitreous hemorrhage

JAMA Ophthalmol. 2015 Oct;133(10):1184-6. doi: 10.1001/jamaophthalmol.2015.2069.


Importance: Rivaroxaban is an anticoagulant prescribed for the management of atrial fibrillation. We describe a correlation between rivaroxaban and spontaneous vitreous hemorrhage.

Observations: Three patients developed spontaneous vitreous hemorrhage after initiating rivaroxaban anticoagulation. All 3 patients were taking an additional anticoagulant at the time of hemorrhage.

Conclusions and relevance: Rivaroxaban is increasingly prescribed as a replacement for warfarin sodium in the management of atrial fibrillation. Rivaroxaban anticoagulation may be associated with spontaneous vitreous hemorrhage. The risk of hemorrhage may be particularly elevated during the transition period when patients are switched from baseline anticoagulant to rivaroxaban therapy and are taking both anticoagulants simultaneously.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Aged, 80 and over
  • Anticoagulants / adverse effects*
  • Atrial Fibrillation / drug therapy
  • Clopidogrel
  • Factor Xa Inhibitors / adverse effects*
  • Humans
  • Male
  • Platelet Aggregation Inhibitors / adverse effects
  • Rivaroxaban / adverse effects*
  • Ticlopidine / adverse effects
  • Ticlopidine / analogs & derivatives
  • Visual Acuity
  • Vitreous Hemorrhage / chemically induced*
  • Vitreous Hemorrhage / physiopathology
  • Warfarin / adverse effects


  • Anticoagulants
  • Factor Xa Inhibitors
  • Platelet Aggregation Inhibitors
  • Warfarin
  • Rivaroxaban
  • Clopidogrel
  • Ticlopidine