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The following is a summary of “Submacular hemorrhage rates following anti-vascular endothelial growth factor injections for exudative age-related macular degeneration,” published in the October 2024 issue of Ophthalmology by Kaufmann et al. 

Researchers conducted a retrospective study to compare the rates in patients of submacular hemorrhage (SMH) receiving different anti-VEGF injections.  

They analyzed data from a nationwide electronic health care database of patients with neovascular age-related macular degeneration (nAMD) and SMH from January 2015 to November 2023 and examined 1,40,915 eyes (9,107 with SMH) using chi-square tests for proportion and 2-sample independent t-tests for visual acuity (VA) data. The primary outcome was the rate of SMH per injection type. Secondary data points included the time between SMH diagnosis and last anti-VEGF injection, number of injections before SMH, treatment interval at the time of SMH, VA before and after SMH, eyes undergoing pars plana vitrectomy (PPV), and VA before and after PPV.  

The results showed bevacizumab was used most (37.8%), followed by aflibercept (35.4%) and ranibizumab (24.7%), SMH rates were higher with bevacizumab (P ≤0.001) but lower with faricimab-svoa (P =0.0004). Patients receiving faricimab-svoa or ranibizumab had shorter intervals (mean and standard deviation (SD) 48.9 (27.9), P <0.02; mean and SD 59.6 (38.2), P = 0.003, respectively) between SMH diagnosis and last injection. Mean VA before and after SMH did not differ by injection type among all patients, PPV rates were 52 (1.51%) for bevacizumab, 4 (8.7%) for brolucizumab-dbII, 58 (1.8%) for aflibercept, 41 (1.8%) for ranibizumab, and 3 (1.9%) for faricimab-svoa. Mean VA before and after SMH did not differ by injection type in patients undergoing PPV.  

They concluded faricimab may be more protective than other anti-VEGF injections against patients with SMH and nAMD.   

Source: ajo.com/article/S0002-9394(24)00486-0/abstract