To the Editor: Warfarin is frequently used in the same population that is at risk of age-related macular degeneration (ARMD), the commonest cause of blindness in the elderly. A recent report has suggested that warfarin may cause severe intraocular haemorrhage and loss of vision in the minority of patients who have the neovascular form of ARMD.1 We have also seen this occur in patients taking warfarin. There are methodological imperfections in the report, and the association is certainly not proven. Nevertheless, it would seem prudent to exercise some caution in the use of warfarin in patients who are or may be at risk. Our preliminary recommendations (pending a prospective study) are:
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- Royal Victorian Eye and Ear Hospital, East Melbourne, VIC.
- 1. Tilanus MAD, Vaandrager W, Cuypers MNM, et al. Relationship between anticoagulant medication and massive intraocular haemorrhage in age related macular degeneration. Graefes Arch Clin Exp Ophthalmol 2000; 238: 482-485.