Real-world insights on switching aflibercept dosage for enhanced outcomes in age-related macular degeneration (RISE-AMD): Safety data.

PURPOSE: To evaluate real-world safety experience with aflibercept 8 mg in a large case series of patients with neovascular age-related macular degeneration (nAMD).

METHODS

Due to a high proportion of patients on short treatment intervals, patients with nAMD at a Danish tertiary retina clinic were systematically switched to aflibercept 8 mg. Safety data from May 2024 to October 2025 were obtained through a retrospective review of medical records by an experienced retina specialist and an additional reviewer. Symptomatic intraocular pressure (IOP) increase was defined as any symptom (e.g. pain) in conjunction with IOP > 21 mmHg.

RESULTS

In total, 8675 intravitreal injections of aflibercept 8 mg were administered in 1429 eyes with nAMD, including 139 glaucomatous eyes. A total of 25 AEs were reported (2.88 per 1000 injections). Intraocular inflammation (IOI) was reported in 11 eyes (1.27 per 1000 injections), with 10 eyes being managed with topical dexamethasone, while one case required vitrectomy. Symptomatic IOP increase was observed in 10 cases (1.15 per 1000 injections). The occurrence of symptomatic IOP increase did not differ between glaucomatous and non-glaucomatous eyes (p = 0.24). Two cases of bacterial endophthalmitis were registered. No case of retinal vasculitis or retinal vascular occlusion was observed.

CONCLUSION

Incidence rates of symptomatic IOP increase and IOI were generally low. Despite a large glaucoma cohort, the higher incidence rate of symptomatic IOP increase in glaucomatous eyes did not reach statistical significance.