Hemorrhagic complications after intravitreal ranibizumab injection for polypoidal choroidal vasculopathy

Can J Ophthalmol. 2012 Apr;47(2):170-5. doi: 10.1016/j.jcjo.2012.01.005. Epub 2012 Mar 13.

Abstract

Objective: To evaluate clinical features and risk factors for hemorrhagic complications in eyes with polypoidal choroidal vasculopathy (PCV) after intravitreal ranibizumab injection.

Design: Retrospective case series.

Participants: The charts of 54 patients with PCV who had received intravitreal ranibizumab 0.5 mg.

Methods: The study was conducted as a retrospective chart review of 54 patients with PCV who had received intravitreal ranibizumab 0.5 mg. Analysis of 2 groups was based on mean PCV lesion size: < 15mm(2) (n = 24); or ≥ 15mm(2) (n = 32). The occurrence of fresh postoperative subretinal hemorrhage, best corrected visual acuity, systemic disease, and medication history were documented and analyzed.

Results: The mean injection number was 3.3 ± 0.7 (range, 1 to 6), with a mean follow-up of 7.4 ± 2.8 months (range, 4 to 14 months). During the follow-up period, postoperative subretinal hemorrhage was observed in 5 (8.9%) of 56 eyes. Occurrence of postoperative hemorrhage was significantly increased in the group with large PCV size (p = 0.01). Pars plana vitrectomy was performed for postoperative bleeding that resulted in vitreous hemorrhage in 1 eye (1.8%). Various systemic diseases and medication with an anticoagulant had no correlation with occurrence of hemorrhagic complications.

Conclusions: Subretinal hemorrhage after ranibizumab injection can occur in patients with PCV. When considering ranibizumab injection for treatment of a large PCV lesion, the risk for hemorrhagic complications should be considered.

MeSH terms

  • Aged
  • Angiogenesis Inhibitors / administration & dosage
  • Angiogenesis Inhibitors / adverse effects*
  • Antibodies, Monoclonal, Humanized / administration & dosage
  • Antibodies, Monoclonal, Humanized / adverse effects*
  • Choroid / blood supply
  • Choroid Diseases / drug therapy*
  • Coloring Agents
  • Fluorescein Angiography
  • Humans
  • Indocyanine Green
  • Intravitreal Injections
  • Male
  • Middle Aged
  • Polyps / drug therapy*
  • Ranibizumab
  • Retinal Hemorrhage / chemically induced*
  • Retinal Hemorrhage / surgery
  • Retrospective Studies
  • Risk Factors
  • Tomography, Optical Coherence
  • Visual Acuity / physiology
  • Vitrectomy

Substances

  • Angiogenesis Inhibitors
  • Antibodies, Monoclonal, Humanized
  • Coloring Agents
  • Indocyanine Green
  • Ranibizumab