Safety of Intravitreal Injections in Patients Receiving Warfarin Anticoagulation

• Published in: American journal of ophthalmology Vol. 144; no. 3; pp. 451 - 453
• Main Authors: Dayani, Pouya N, Siddiqi, Omar K, Holekamp, Nancy M
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.09.2007; Elsevier; Elsevier Limited
• Subjects: Aged; Aged, 80 and over; Angiogenesis Inhibitors - adverse effects; Angiogenesis Inhibitors - therapeutic use; Anticoagulants - adverse effects; Anticoagulants - therapeutic use; Aptamers, Nucleotide - adverse effects; Aptamers, Nucleotide - therapeutic use; Aspirin - therapeutic use; Biological and medical sciences; Celecoxib; Choroidal Neovascularization - drug therapy; Choroidal Neovascularization - etiology; Diabetic retinopathy; Drug therapy; Drug Therapy, Combination; Eye Hemorrhage - chemically induced; Female; Health Insurance Portability & Accountability Act 1996-US; Humans; Injections; Macular degeneration; Macular Degeneration - complications; Macular Degeneration - drug therapy; Male; Medical sciences; Middle Aged; Miscellaneous; Ophthalmology; Pyrazoles - therapeutic use; Retrospective Studies; Sulfonamides - therapeutic use; Vascular Endothelial Growth Factor A - antagonists & inhibitors; Vitreous Body; Warfarin - adverse effects; Warfarin - therapeutic use; New York; Human; Antivitamin K; Warfarin; Toxicity; Coumarine derivatives; Vitreous body; Anticoagulant; Injection; Ophthalmology; Safety
• ISSN: 0002-9394; 1879-1891
• DOI: 10.1016/j.ajo.2007.05.006

Purpose To evaluate the safety of intravitreal Macugen (OSI/Eyetech, New York, New York, USA) injections among patients receiving warfarin anticoagulation. Design Retrospective chart review. Methods A search was conducted for patients treated with intravitreal Macugen for choroidal neovascularization resulting from age-related macular degeneration (AMD). Inclusion criteria included patients receiving warfarin anticoagulation in whom therapy was maintained. Results The review identified 31 patients (32 eyes) who underwent 102 intravitreal Macugen injections while receiving warfarin anticoagulation. The mean and median number of Macugen injections per patient was three. No intraoperative or immediate postoperative hemorrhagic complications were noted. One patient experienced an acute submacular hemorrhage 35 days after the third Macugen injection. There were no other hemorrhagic events among the remaining patients. Conclusions The retrospective chart review of patients treated with intravitreal Macugen for choroidal neovascularization resulting from AMD while receiving warfarin therapy suggests that patients may undergo intravitreal injections safely without cessation of anticoagulation therapy.