Aflibercept high-dose (8mg) related intraocular inflammation (IOI) – a case series

Abstract Background Monitoring for potential inflammatory events following intravitreal anti-vascular endothelial factor (VEGF) injection is crucial with the use of new agents such as aflibercept 8 mg. Despite a safety profile comparable to aflibercept 2 mg in pivotal and phase 3 studies, reporting...

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Main Authors: Laura Hoffmann, Stephan Michels, Chiara Eandi, Muntadher Al Karam, Eva C. de Oliveira Figueiredo, Katja Hatz
Format: Article
Language:English
Published: BMC 2024-12-01
Series:BMC Ophthalmology
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Online Access:https://doi.org/10.1186/s12886-024-03788-w
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Summary:Abstract Background Monitoring for potential inflammatory events following intravitreal anti-vascular endothelial factor (VEGF) injection is crucial with the use of new agents such as aflibercept 8 mg. Despite a safety profile comparable to aflibercept 2 mg in pivotal and phase 3 studies, reporting such cases in clinical practice helps evaluate potential risk of these agents. Case presentation In this case series, a cluster of 8 patients manifesting acute intraocular inflammation (IOI) after intravitreal aflibercept 8 mg injection at three different centers are described. All patients developed inflammation of the vitreous and anterior chamber within 2–17 days following the injection. All subjects had previously received intravitreal anti-vascular endothelial growth factor (VEGF) therapy (ranibizumab, aflibercept 2 mg or faricimab) without injection-related complications. No signs of vasculitis, papillitis or retinitis were noted. In view of the clinical presentation, vitreous cultures were not performed. Inflammation resolved with topical steroids and non-steroidal anti-inflammatory drugs over a course of 11–24 days with excellent visual recovery. Conclusions We report a cluster of injection-related ocular inflammation following intravitreal aflibercept 8 mg with at present unknown cause. It underlines the need for clinical awareness to detect such cases despite the low-risk safety profile in pivotal studies.
ISSN:1471-2415