Key result
A 63-year-old man on rivaroxaban experienced recurrent subretinal hemorrhage, which was successfully managed with pneumatic displacement and ranibizumab, improving visual acuity from 20/200 to 20/30.
Case Report (n=1)
Rivaroxaban use may be associated with recurrent subretinal hemorrhage in patients with choroidal neovascular membrane, which can be successfully managed with pneumatic displacement and ranibizumab.
Rivaroxaban may be associated with recurrent subretinal hemorrhage in CNV; single case leaves open need for prospective studies before practice change.
In Brief Purpose: To report a case of spontaneous recurrent significant subretinal hemorrhage in a patient on rivaroxaban (Xarelto). Methods: A case report of a 63-year-old man on rivaroxaban with peripapillary choroidal neovascular membrane and macula involving subretinal hemorrhage. Results: Improvement in visual acuity from 20/200 to 20/30 and restoration of foveal contour after pneumatic displacement of hemorrhage with C3F8 gas and subsequent treatment with ranibizumab. Conclusion: The authors report a case of recurrent subretinal hemorrhage associated with rivaroxaban use. Pneumatic displacement and subsequent treatment of choroidal neovascular membrane with intravitreal ranibizumab improved visual acuity. Rivaroxaban is a direct factor Xa inhibitor used for the treatment of blood clots and the prevention of stroke. Intraocular hemorrhage was reported in less than 1% of patients in clinical trials. The authors present a case of recurrent subretinal hemorrhage in a patient with choroidal neovascular membrane on rivaroxaban and its management.
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Boyce et al. (2015) conducted a case report in Recurrent subretinal hemorrhage (n=1). Rivaroxaban was evaluated on Visual acuity and foveal contour. A 63-year-old man on rivaroxaban experienced recurrent subretinal hemorrhage, which was successfully managed with pneumatic displacement and ranibizumab, improving visual acuity from 20/200 to 20/30.
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