Mild Intraocular Inflammation More Frequent with Aflibercept 8 mg in Real-World Use, Study Finds

A new study published in JAMA Ophthalmology reports a higher real-world incidence of mild intraocular inflammation (IOI) following intravitreal injections of aflibercept 8 mg compared to rates observed in clinical trials. The findings underscore the importance of monitoring and patient education in routine ophthalmic practice.

Study Overview and Patient Population

Led by Karoline E. Binder, MD, of the Technical University of Munich, the retrospective analysis assessed IOI rates in 41 patients who received a total of 136 intravitreal aflibercept 8 mg injections. The study included patients with:

       • Neovascular age-related macular degeneration (nAMD) – 23 patients

       • Diabetic macular edema (DME) – 18 patients

Key Findings: Inflammation Incidence and Management

       • Five patients developed mild sterile IOI within 1 to 3 days post-injection

       • Incidence per injection: 3.7%

       • Incidence per patient: 12%

Only one case of inflammation occurred after a first-time injection; the remaining four occurred in patients with prior aflibercept exposure.

All affected individuals were managed successfully using local anti-inflammatory therapies (topical or subconjunctival corticosteroids), and two patients also required oral corticosteroids. Importantly, no loss in best-corrected visual acuity (BCVA) was reported after inflammation resolved.

Clinical Implications

While the observed IOI cases were considered mild, the authors caution that these findings highlight the need for:

       • Careful evaluation of patient-associated risk factors

       • Thorough patient education prior to treatment

       • Close post-injection monitoring in clinical practice

“Although the IOI found in this series can be considered mild, careful evaluation of patient-associated risk factors and thorough patient education are warranted,” the authors concluded.

Reference:

Karoline E. Binder et al, Noninfectious Intraocular Inflammation After Intravitreal Aflibercept, JAMA Ophthalmology (2025). DOI: 10.1001/jamaophthalmol.2025.0969