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Aflibercept high-dose (8mg) related intraocular inflammation (IOI) – a case series

Authors: Hoffmann, Laura; Michels, Stephan; Eandi, Chiara; Karam, Muntadher Al; Figueiredo, Eva C. de Oliveira; Hatz, Katja;

Aflibercept high-dose (8mg) related intraocular inflammation (IOI) – a case series

Abstract

Monitoring for potential inflammatory events following intravitreal anti-vascular endothelial factor (VEGF) injection is crucial with the use of new agents such as aflibercept 8 mg. Despite a safety profile comparable to aflibercept 2 mg in pivotal and phase 3 studies, reporting such cases in clinical practice helps evaluate potential risk of these agents.In this case series, a cluster of 8 patients manifesting acute intraocular inflammation (IOI) after intravitreal aflibercept 8 mg injection at three different centers are described. All patients developed inflammation of the vitreous and anterior chamber within 2-17 days following the injection. All subjects had previously received intravitreal anti-vascular endothelial growth factor (VEGF) therapy (ranibizumab, aflibercept 2 mg or faricimab) without injection-related complications. No signs of vasculitis, papillitis or retinitis were noted. In view of the clinical presentation, vitreous cultures were not performed. Inflammation resolved with topical steroids and non-steroidal anti-inflammatory drugs over a course of 11-24 days with excellent visual recovery.We report a cluster of injection-related ocular inflammation following intravitreal aflibercept 8 mg with at present unknown cause. It underlines the need for clinical awareness to detect such cases despite the low-risk safety profile in pivotal studies.

Keywords

Adverse event, Male, Aged, 80 and over, Vascular Endothelial Growth Factor A, Endophthalmitis, Recombinant Fusion Proteins, Anti-VEGF, High dose, Case Report, Angiogenesis Inhibitors, RE1-994, Middle Aged, Humans; Receptors, Vascular Endothelial Growth Factor/administration & dosage; Recombinant Fusion Proteins/administration & dosage; Recombinant Fusion Proteins/adverse effects; Intravitreal Injections; Female; Male; Aged; Angiogenesis Inhibitors/adverse effects; Angiogenesis Inhibitors/administration & dosage; Middle Aged; Aged, 80 and over; Endophthalmitis/diagnosis; Endophthalmitis/drug therapy; Endophthalmitis/chemically induced; Vascular Endothelial Growth Factor A/antagonists & inhibitors; Uveitis/drug therapy; Uveitis/diagnosis; Uveitis/chemically induced; Adverse event; Aflibercept 8 mg; Anti-VEGF; High dose; Intraocular inflammation, Uveitis, Ophthalmology, Receptors, Vascular Endothelial Growth Factor, Intravitreal Injections, Intraocular inflammation, Humans, Female, Aflibercept 8 mg, Adverse event; Aflibercept 8 mg; Anti-VEGF; High dose; Intraocular inflammation, Aged

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    influence
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    This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
11
Top 10%
Top 10%
Top 10%
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gold