SEARCHCOHORTophthalmology, retina

cohort·ophthalmology, retina, cardiology, hematology, observational study·PMC10148780

Antiplatelet and anticoagulant therapy in patients with submacular hemorrhage caused by neovascular age-related macular degeneration

Graefe's Archive for Clinical and Experimental Ophthalmology · 6 authors, 2 centres

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TL;DR

A retrospective cohort study analyzed 115 patients with surgically treated submacular hemorrhage (SMH) from neovascular AMD.

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A retrospective cohort study analyzed 115 patients with surgically treated submacular hemorrhage (SMH) from neovascular AMD. Patients on blood-thinning therapy (83 patients) had a significantly larger mean SMH size (35.92 mm^2^) compared to those not on therapy (21.91 mm^2^, p=0.001). The findings suggest an association between blood-thinning medications and the severity of SMH, warranting careful clinical evaluation of therapy indications in AMD patients.

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cohort

SPECIALTY

ophthalmology

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ORIGINAL PAPER

PMC10148780

Antiplatelet and anticoagulant therapy in patients with submacular hemorrhage caused by neovascular age-related macular degeneration

Graefe's Archive for Clinical and Experimental Ophthalmology

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ABSTRACT

Abstract Purpose Patients with extensive submacular hemorrhage (SMH) caused by age-related macular degeneration (AMD) have a poor visual prognosis despite surgical intervention. Systemic blood-thinning drugs, which are commonly prescribed in the same age group, are known to increase the risk of severe hemorrhage in many parts of the body. This study aimed to investigate whether systemic blood-thinning drugs have an impact on the severity of SMH and if there are differences between the different types of blood-thinning medication. Methods We reviewed the medical records of patients who suffered from surgically treated SMH between 2020 and 2022. All patients received a full ophthalmologic examination upon presentation including best-corrected visual acuity (BCVA) and optical coherence tomography. Other characteristics that were recorded included size of hemorrhage, blood-thinning therapy, and reason for intake. Results A total of 115 patients with a mean age of 82 years were included in this retrospective analysis. Eighty-three patients (72.2%) were on blood-thinning therapy. The mean size of SMH was 32.01 mm 2 . Mean BCVA at initial presentation was 1.63 logMAR and 1.59 logMAR 1 year after surgery. The size of SMH was significantly larger in patients on blood-thinning medication (35.92 mm 2 vs. 21.91 mm 2 ) ( p = 0.001) and their BCVA postoperatively was worse with 1.68 logMAR compared to 1.30 logMAR after 1 year ( p = 0.503). Patients with vitamin K antagonists had larger SMH size and worse outcomes regarding BCVA compared to direct oral anticoagulants. Conclusion Blood thinners in patients with AMD affect the severity of SMH. Consequently, the indication for their intake should be critically evaluated. Keywords: AMD, Antiplatelet therapy, Anticoagulant therapy, Blood thinners, Neovascular AMD, Submacular hemorrhage

CITATION EXPORT

Constance Weber, Maria Bertelsmann, Zoe Kiy et al.. Antiplatelet and anticoagulant therapy in patients with submacular hemorrhage caused by neovascular age-related macular degeneration. Graefe's Archive for Clinical and Experimental Ophthalmology. (2022). https://doi.org/10.1007/s00417-022-05885-2

AUTHORS

6 · 2 CENTRES

Constance Weber, Maria Bertelsmann, Zoe Kiy, Isabel Stasik, Frank G Holz, Raffael Liegl

1Department of Ophthalmology, University of Bonn, Ernst-Abbe-Str. 2, 53127 Bonn, Germany
2Department of Anesthesiology and Critical Care Medicine, University of Münster, Münster, Germany