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Aflibercept injections can cause sterile intraocular inflammation, presenting as blurry vision and inflammation within 2.6 days. While most cases resolve with steroids, some patients experience lasting vision loss.

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Area of Science:

  • Ophthalmology
  • Retina
  • Pharmacology

Background:

  • Aflibercept (EYLEA) is a widely used anti-VEGF agent for retinal diseases.
  • Reports of sterile intraocular inflammation following aflibercept injections have increased.
  • Understanding the characteristics and outcomes of this adverse event is crucial for patient safety.

Purpose of the Study:

  • To describe the clinical characteristics and outcomes of sterile intraocular inflammation after aflibercept injections.
  • To analyze presenting symptoms, management strategies, and visual acuities in affected patients.

Main Methods:

  • A case series of 68 eyes from 66 patients reporting sterile intraocular inflammation post-aflibercept injection.
  • Exclusion criteria included intravitreal antibiotic injection and follow-up less than 7 days.
  • Data collected included signs, symptoms, injection details, management, and visual outcomes.

Main Results:

  • Most patients (93%) presented with blurry vision within 2.6 days.
  • Intraocular inflammation (vitritis and/or anterior chamber reaction) was present in all patients.
  • While 79% resolved with topical steroids, 15% experienced vision loss, associated with early presentation and decreased initial visual acuity.

Conclusions:

  • This is the largest study on aflibercept-related sterile intraocular inflammation, excluding antibiotic-injected eyes.
  • Early presentation with inflammation is common, but significant vision loss can occur in a minority.
  • Close monitoring and prompt treatment are essential for managing this adverse event.