Patients with wet age-related macular degeneration, up to 2 times risk of severe bleeding in the eye when taking antithrombotic drugs
Oct 16, 2025
A team of ophthalmologists Woo Woo-joon and Kim Min-seok at Seoul National University Bundang Hospital announced a study that if wet age-related macular degeneration patients take antithrombotic drugs to treat cardiovascular diseases, the risk of severe bleeding in the eye that requires surgery increases by up to twice.
A disease in which an object is distorted due to damage to the macula, which is focused in the middle of the retina, is called macular degeneration. Macular degeneration is largely divided into wetness (about 10%) and dryness (about 90%), and 'humidity' is the name given in the sense that water or blood leaks into the retina and becomes humid. In addition, as the age increases, the frequency of macular degeneration increases, so it is collectively called 'wet age-related macular degeneration'.
In this wet age-related macular degeneration, abnormal new blood vessels actually grow, causing fluid or blood to leak out of the blood vessels, causing bleeding and swelling in the retina. Intraocular bleeding is a fatal complication of macular degeneration and is severe enough to require vitrectomy, and if not treated in time, it can lead to rapid vision loss and permanent vision loss.
Another problem is the cardiovascular disease that macular degeneration patients accompany as they age. For the treatment of hypertension, atrial fibrillation, coronary artery disease, and cerebral infarction, taking 'antithrombotic agents such as anticoagulants (such as warfarin) or antiplatelet drugs (such as aspirin) is essential.
The problem was that such antithrombotic agents could increase the risk of intraocular bleeding in patients with wet age-related macular degeneration, but studies so far have been limited to small single-center studies, making it difficult to draw a clear conclusion.
Professor Woo Woo-joon and Professor Min-seok's team conducted a study from 2014 to 2023 to 94,449 new patients with wet age-related macular degeneration over the age of 40 using data from the Health Insurance Review and Assessment Service to confirm the association between taking antithrombotic drugs and severe bleeding in the eyeball.
While conducting a retrospective cohort study on them, the research team also conducted a case-control study by selecting a case group (1,622) diagnosed with severe intraocular bleeding and a control group (6,488) that matched the vitreous resection based on gender and age.
As a result of the study, the patient group who took antithrombotic drugs had a 1.15 times (15%) higher risk of intraocular bleeding requiring vitreous resection than the non-dose group.
In the case group-control study, the specific risk of each drug taken was identified. The risk of intraocular bleeding increased 1.9 times when only anticoagulants were taken, and 1.4 times when only antiplatelet drugs were taken. Patients who took both anticoagulants and antiplatelet drugs had a 2.3 times increased risk of bleeding compared to those who did not.
In particular, the risk of bleeding was higher in patients who took antithrombotic drugs steadily, and the risk of intraocular bleeding increased by 1.69 times in patients with high adherence to medication. This means that the cumulative effect of the drug continuously increases the tendency of bleeding. In addition, men, relatively young age, and diabetes have been identified as major factors that increase the risk of bleeding.
Professor Kim Min-seok, an ophthalmologist at Seoul National University Bundang Hospital, explained "This study is meaningful in that it clearly identified the relationship between the use of antithrombotic drugs and intraocular bleeding, which was not revealed in previous studies" In particular, the study further strengthened its clinical significance by analyzing only severe bleeding cases requiring vitreous resection."
Corresponding author Professor Woo Woo-jun of ophthalmology at Seoul National University Bundang Hospital said, `The prescription of antithrombotic drugs in patients with wet age-related macular degeneration can increase the risk of intraocular bleeding, especially in patients with higher drug compliance""If macular degeneration patients are accompanied by medical conditions, customized prescriptions and monitoring strategies through consultation with ophthalmologists are important" he stressed.
Meanwhile, the study was published in the international journal 'JAMA Network Open" published by the American Medical Association (JAMA).
A disease in which an object is distorted due to damage to the macula, which is focused in the middle of the retina, is called macular degeneration. Macular degeneration is largely divided into wetness (about 10%) and dryness (about 90%), and 'humidity' is the name given in the sense that water or blood leaks into the retina and becomes humid. In addition, as the age increases, the frequency of macular degeneration increases, so it is collectively called 'wet age-related macular degeneration'.
In this wet age-related macular degeneration, abnormal new blood vessels actually grow, causing fluid or blood to leak out of the blood vessels, causing bleeding and swelling in the retina. Intraocular bleeding is a fatal complication of macular degeneration and is severe enough to require vitrectomy, and if not treated in time, it can lead to rapid vision loss and permanent vision loss.
Another problem is the cardiovascular disease that macular degeneration patients accompany as they age. For the treatment of hypertension, atrial fibrillation, coronary artery disease, and cerebral infarction, taking 'antithrombotic agents such as anticoagulants (such as warfarin) or antiplatelet drugs (such as aspirin) is essential.
The problem was that such antithrombotic agents could increase the risk of intraocular bleeding in patients with wet age-related macular degeneration, but studies so far have been limited to small single-center studies, making it difficult to draw a clear conclusion.
Professor Woo Woo-joon and Professor Min-seok's team conducted a study from 2014 to 2023 to 94,449 new patients with wet age-related macular degeneration over the age of 40 using data from the Health Insurance Review and Assessment Service to confirm the association between taking antithrombotic drugs and severe bleeding in the eyeball.
While conducting a retrospective cohort study on them, the research team also conducted a case-control study by selecting a case group (1,622) diagnosed with severe intraocular bleeding and a control group (6,488) that matched the vitreous resection based on gender and age.
As a result of the study, the patient group who took antithrombotic drugs had a 1.15 times (15%) higher risk of intraocular bleeding requiring vitreous resection than the non-dose group.
In the case group-control study, the specific risk of each drug taken was identified. The risk of intraocular bleeding increased 1.9 times when only anticoagulants were taken, and 1.4 times when only antiplatelet drugs were taken. Patients who took both anticoagulants and antiplatelet drugs had a 2.3 times increased risk of bleeding compared to those who did not.
In particular, the risk of bleeding was higher in patients who took antithrombotic drugs steadily, and the risk of intraocular bleeding increased by 1.69 times in patients with high adherence to medication. This means that the cumulative effect of the drug continuously increases the tendency of bleeding. In addition, men, relatively young age, and diabetes have been identified as major factors that increase the risk of bleeding.
Professor Kim Min-seok, an ophthalmologist at Seoul National University Bundang Hospital, explained "This study is meaningful in that it clearly identified the relationship between the use of antithrombotic drugs and intraocular bleeding, which was not revealed in previous studies" In particular, the study further strengthened its clinical significance by analyzing only severe bleeding cases requiring vitreous resection."
Corresponding author Professor Woo Woo-jun of ophthalmology at Seoul National University Bundang Hospital said, `The prescription of antithrombotic drugs in patients with wet age-related macular degeneration can increase the risk of intraocular bleeding, especially in patients with higher drug compliance""If macular degeneration patients are accompanied by medical conditions, customized prescriptions and monitoring strategies through consultation with ophthalmologists are important" he stressed.
Meanwhile, the study was published in the international journal 'JAMA Network Open" published by the American Medical Association (JAMA).
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This article was translated by Naver AI translator.
