Increased Risk of Intraocular Inflammation with Aflibercept Injections in Real-World Practice

Recent research highlights that intraocular inflammation (IOI), a potential side effect of intravitreal aflibercept injections, appears to be more common in real-world clinical settings compared to controlled trials. A study published online on May 1, 2025, in JAMA Ophthalmology evaluated the occurrence of mild sterile IOI following aflibercept treatment.

The study, led by Dr. Karoline E. Binder from the Technical University of Munich, involved 41 patients receiving a total of 136 injections of 8 mg aflibercept, primarily for neovascular age-related macular degeneration and diabetic macular edema. The findings revealed that five patients developed mild sterile IOI within one to three days after injection. The incidence rate was approximately 3.7% per injection and 12% per patient. Notably, only one patient experienced inflammation after the initial dose, while the other four had prior injections.

All affected patients received localized anti-inflammatory treatments, such as topical or subconjunctival corticosteroids, with two also receiving systemic corticosteroids. Despite the inflammation, there was no impact on their visual acuity once the IOI resolved. The study authors emphasized that, although the observed IOI was mild, healthcare providers should carefully assess patient risk factors before treatment and ensure thorough patient education about potential side effects.

This research underscores the importance of vigilant monitoring during aflibercept therapy outside the controlled environment of clinical trials and highlights that mild intraocular inflammation is an important consideration in real-world practice.

Source: https://medicalxpress.com/news/2025-05-intraocular-inflammation-common-aflibercept-real.html