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Off-label prescribing in ophthalmology: a retrospective analysis.
Claudio Bucolo1,2,3, Lucia Gozzo4, Laura Terranova2
1Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy.
Frontiers in Pharmacology
|June 29, 2026
Summary
Ophthalmologists frequently use off-label drug prescriptions for ocular conditions. Anti-vascular endothelial growth factor (VEGF) drugs and mitomycin C are common, highlighting the evolving landscape of ophthalmic drug use.
Area of Science:
- Ophthalmology
- Pharmacology
- Clinical Medicine
Background:
- Off-label drug use is common in ophthalmology due to limited approved treatments for ocular diseases and complex surgeries.
- The study addresses the need for analyzing prescription patterns to understand current practices.
Purpose of the Study:
- To analyze off-label drug prescriptions in ophthalmology from January 2014 to December 2024.
- To identify trends and key drugs used in off-label ophthalmic practice.
Main Methods:
- Retrospective analysis of 233 off-label prescriptions for 225 patients.
- Data collected from the Department of Ophthalmology, University Hospital of Catania, Italy.
Main Results:
- Mitomycin C was prominent (34.3%) for trabeculectomy in 2015-2016.
- Anti-VEGF agents (bevacizumab, ranibizumab, aflibercept) became major contributors later.
- Other drugs like 5-fluorouracil, dexamethasone, alteplase, and antifungals were also used off-label for specific conditions.
Conclusions:
- Off-label prescribing in ophthalmology is dynamic and increasing.
- Standardized, evidence-based international guidelines are needed for off-label drug use to improve patient outcomes.
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