INTRAVITREAL RANIBIZUMAB THERAPY for NEOVASCULAR AGE-RELATED MACULAR DEGENERATION and the RISK of STROKE: A National Sample Cohort Study

Purpose: To evaluate the risk of stroke after ranibizumab treatment for neovascular age-related macular degeneration. Methods: National registry data for 1,025,340 random subjects in the year 2002 were used. The ranibizumab group comprised patients diagnosed with neovascular age-related macular degeneration and treated with ranibizumab between 2009 and 2013 (n 467). The two types of comparison groups were defined as comorbidity-matched controls (n 2,330) comprised of randomly selected patients (5 per age-related macular degeneration patient), who were matched to the ranibizumab group according to sociodemographic factors, hypertension, atrial fibrillation, and the Charlson comorbidities index, and sociodemographic-matched controls (n 2,331) matched according to sociodemographic factors only. Each sampled patient was tracked until 2013. The Cox proportional hazard regression was used. Results: Stroke occurred in 6.6% of the ranibizumab group versus 7.0% of the comorbidity-matched controls and 6.7% of the sociodemographic-matched controls; these differences were not statistically significant. The overall incidence of stroke was similar for the ranibizumab group versus the comorbidity-matched controls and sociodemographic-matched controls, based on the multivariable Cox regression (hazard ratio 0.88; 95% confidence interval, 0.60-1.30; hazard ratio 0.95, 95% confidence interval, 0.64-1.41, respectively). Conclusion: Ranibizumab treatment for neovascular age-related macular degeneration did not increase the overall risk of stroke, compared with comorbidity-matched controls or sociodemographic-matched controls.