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Risk of Retinal Detachment After Intravitreal Injection of Anti-VEGF: A Systematic Review and Meta-Analysis.

David Mikhail¹, Brendan K Tao², Philip Yu³

¹From the Temerty Faculty of Medicine (D.M., L.C.), University of Toronto, Toronto, Ontario, Canada.

American Journal of Ophthalmology

|May 31, 2026

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Summary

Retinal detachment (RD) risk after intravitreal anti-VEGF injections is low, with a 0.012% per-injection rate. The per-eye risk is 0.08%, highlighting the need for standardized reporting in future studies.

Area of Science:

Ophthalmology
Medical Interventions
Retinal Diseases

Background:

Intravitreal anti-VEGF injections are common for retinal conditions.
Retinal detachment (RD) is a known complication, but its incidence is not well-quantified.

Purpose of the Study:

To systematically review and meta-analyze the pooled risk of RD following intravitreal injections (IVI) of anti-VEGF agents.
To provide clinicians with data to contextualize RD risk for informed consent.

Main Methods:

Systematic review and meta-analysis following PRISMA guidelines.
Searched MEDLINE, Embase, and Cochrane CENTRAL from inception to January 18, 2026.
Included studies reporting RD risk after anti-VEGF IVI for various retinal conditions.
Performed random-effects single-arm meta-analysis of proportions.

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Main Results:

Included 12 studies with 834,814 injections and 119 RD events.
Pooled risk of rhegmatogenous RD (RRD) was 0.012% per injection (1 in 8675).
Per-eye risk of RRD was 0.08% (1 in 1250 eyes).
Tractional RD risk was 3.6% in one study of severe PDR.

Conclusions:

RRD following anti-VEGF IVI is uncommon, with low per-injection and per-eye risks.
Per-eye risk is more relevant for long-term treatment but has wider uncertainty.
Further research should standardize RD subtype reporting and identify procedural risk factors.