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Updated: Feb 7, 2026
A Simple Bioassay for the Evaluation of Vascular Endothelial Growth Factors
Published on: March 15, 2016
Oral Anti-Vascular Endothelial Growth Factor Drugs and Ocular Adverse Events
Frederick T Fraunfelder1, Frederick W Fraunfelder2
11 Department of Ophthalmology, Casey Eye Institute, Oregon Health and Science University , Portland, Oregon.
Purpose:
To evaluate possible associations between oral anti-vascular endothelial growth factor (VEGF) drugs and ocular side effects.
Methods:
Spontaneous reports were collected and evaluated by the National Registry of Drug-Induced Ocular Side Effects on the three oral anti-VEGF drugs (pazopanib, sorafenib, and sunitinib) for possible ocular side effects.
Results:
Reported side effects include blurred or decreased vision (389 cases); periocular or eyelid edema (273 cases); superficial anterior segment toxicity (270 cases); conjunctival, retinal, or vitreous bleeding (77 cases); retinal detachments (RDs) or retinal tears (RTs) (75 cases); extraocular muscle disorders, including ptosis (51 cases); discoloration of eyelashes (36 cases); retinal arterial or venous occlusions (26 cases); optic nerve disorders, including papilledema and ischemic optic neuropathy (21 cases); uveitis (10 cases); and macular edema (7 cases). Spontaneous reports of possible RD or RT have been associated with pazopanib (31 RDs and 12 RTs), sunitinib (24 RDs and 0 RT), and sorafenib (7 RDs and 2 RTs).
Conclusions:
Oral anti-VEGF drugs can cause superficial anterior segment side effects. Pazopanib has been reported to be possibly linked to RDs and RTs. This study suggests that sorafenib and sunitinib are suspected as well. RDs were seldom differentiated into rhegmatogenous retinal detachments (RRDs) or non-RRDs. The association of oral anti-VEGF drugs with RRD and RT are unclassified although this suggests a "signal" requiring further study. The association of oral anti-VEGF drugs with serous retinal detachments, while rare, is plausible. Patients on this class of drugs should be instructed to seek immediate ophthalmic consultation if retinal symptoms occur.
Insights
Oral anti-vascular endothelial growth factor (VEGF) drugs can cause various ocular side effects, including vision changes and retinal issues. Pazopanib, sorafenib, and sunitinib may be linked to retinal detachments and tears, warranting further investigation.
Area of Science:
- Ophthalmology
- Pharmacology
- Oncology
Background:
- Vascular Endothelial Growth Factor (VEGF) inhibitors are crucial in cancer therapy.
- Understanding the ocular side effects of oral anti-VEGF drugs is essential for patient safety.
Purpose of the Study:
- To investigate the potential association between oral anti-VEGF medications and adverse ocular events.
- To identify specific ocular toxicities linked to pazopanib, sorafenib, and sunitinib.
Main Methods:
- Analysis of spontaneous adverse event reports from the National Registry of Drug-Induced Ocular Side Effects.
- Evaluation of reports concerning three oral anti-VEGF drugs: pazopanib, sorafenib, and sunitinib.
Main Results:
- Common side effects included blurred vision, eyelid edema, and anterior segment toxicity.
- Retinal detachments (RDs) or retinal tears (RTs) were reported in 75 cases, with pazopanib, sunitinib, and sorafenib implicated.
- Other reported issues included bleeding, extraocular muscle disorders, and optic nerve disorders.
Conclusions:
- Oral anti-VEGF drugs can induce superficial anterior segment ocular toxicities.
- Pazopanib, sorafenib, and sunitinib are suspected of causing retinal detachments and tears, although further research is needed.
- Patients using these drugs should seek immediate ophthalmic evaluation for any retinal symptoms.
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