Hemorrhagic complications after intravitreal ranibizumab injection for polypoidal choroidal vasculopathy

Abstract

ObjectiveTo evaluate clinical features and risk factors for hemorrhagic complications in eyes with polypoidal choroidal vasculopathy (PCV) after intravitreal ranibizumab injection. DesignRetrospective case series. ParticipantsThe charts of 54 patients with PCV who had received intravitreal ranibizumab 0.5 mg. MethodsThe 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: < 15mm2 (n = 24); or ≥ 15mm2 (n = 32). The occurrence of fresh postoperative subretinal hemorrhage, best corrected visual acuity, systemic disease, and medication history were documented and analyzed. ResultsThe 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. ConclusionsSubretinal 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.