Adverse events and complications associated with intravitreal injection of anti-VEGF agents: a review of literature
Open accessAbstract
Intravitreal injection of anti-vascular endothelial growth factor (VEGF) agents is increasingly used for the treatment of a wide variety of retinal diseases, including age-related macular degeneration, diabetic retinopathy and retinal vascular occlusions, and retinopathy of prematurity. Despite encouraging results in halting the disease and improving the vision, intravitreal injection of anti-VEGF agents may be associated with systemic adverse events and devastating ocular complications. In this review, we provide an overview of safety data for intravitreal injection of common anti-VEGF agents.
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Intravitreal injections carry risks of adverse reactions including inflammation, endophthalmitis, increased intraocular pressure, retinal detachment, hemorrhage, and cataracts, and patient compliance can become an issue due to repeated use.
“Despite these advantages, intravitreal injections also carry risks of adverse reactions, including inflammation, endophthalmitis, increased intraocular pressure, retinal detachment, hemorrhage, and cataracts, and due to the repeated use of these injections in various treatments, patient compliance can become an issue.119,127,129”
From Gene Therapy for Retinal Degenerative Diseases: Progress, Challenges, and Future Directions (2023) · cites this paper as [129]
Increased non-ocular biodistribution of ranibizumab or bevacizumab has been observed with the intravitreal route, causing systemic adverse events such as ecchymosis, gastrointestinal and vaginal hemorrhage, hematoma, increased blood pressure, cerebrovascular accident, myocardial infarctions, iliac artery aneurysm, and death.
“Increased non-ocular biodistribution of ranibizumab or bevacizumab have been observed with the intravitreal route causing systemic adverse events like ecchymosis, gastrointestinal and vaginal hemorrhage, hematoma, increased blood pressure, cerebrovascular accident, myocardial infarctions, iliac artery aneurysm, and death.26,129”
From Gene Therapy for Retinal Degenerative Diseases: Progress, Challenges, and Future Directions (2023) · cites this paper as [129]
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- Schmidt-Erfurth U. Clinical safety of ranibizumab in agerelated macular degeneration. Expert Opin Drug Saf 2010; 9(1): 149-165.
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Alshamrani, M., Sikder, S., Coulibaly, F., Mandal, A., Pal, D., & Mitra, A. K. (2019) · AAPS PharmSciTech · doi:10.1208/s12249-019-1404-1 · Cited by 46 · see citing works
Fan, X., Jiang, K., Geng, F., Lu, W., & Wei, G. (2023) · Advanced Drug Delivery Reviews · doi:10.1016/j.addr.2023.114864 · Cited by 33 · see citing works
Complement Factor B Mediates Ocular Angiogenesis through Regulating the VEGF Signaling Pathway
Murray, H., Qiu, B., Ho, S. Y., & Wang, X. (2021) · International Journal of Molecular Sciences · doi:10.3390/ijms22179580 · Cited by 16 · see citing works
Trivizki, O., Schwartz, S., Negri, N., Loewenstein, A., Rabina, G., & Shulman, S. (2018) · Ophthalmologica · doi:10.1159/000492681 · Cited by 11 · see citing works
- Authors
- Ghasemi Falavarjani, K., & Nguyen, Q. D.
- Affiliations
- University of Nebraska Medical Center (US)
- ORCID
- Nguyen, Q D
- Venue
- Eye
- Published
- 2013-05-31
- Volume
- 27
- Issue
- 7
- Pages
- 787-794
- ISSN
- 0078-5334 (ISSN-L)
- 0950-222X
- 1476-5454
- PMC
- PMC3709385
- OpenAlex
- W2078916806
- Cited by
- 982
- References
- 88
- Citations by year
- 2026: 71 · 2025: 119 · 2024: 110 · 2023: 113 · 2022: 100 · 2021: 111 · 2020: 97 · 2019: 67 · 2018: 64 · 2017: 39 · 2016: 42 · 2015: 33 · 2014: 16
- FWCI
- 5.31
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Eye (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Ophthalmology › Retinal Diseases and Treatments
- Health Sciences › Medicine › Ophthalmology › Ocular Diseases and Behçet’s Syndrome
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Retinal and Macular Surgery
- Keywords
- intravitreal injection, VEGF inhibitors, adverse events, ocular complications, drug safety, age-related macular degeneration, diabetic retinopathy, retinal vascular occlusion, retinopathy of prematurity, systemic adverse events
- MeSH terms
- Cardiovascular Diseases, Eye Diseases, Gastrointestinal Diseases, Hemorrhage, Humans, Kidney Diseases, Retinal Diseases, Angiogenesis Inhibitors, Vascular Endothelial Growth Factor A, Intravitreal Injections, Antibodies, Monoclonal, Humanized
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