Key Takeaways
- Aflibercept 8 mg showed IOP outcomes comparable to aflibercept 2 mg through 96 weeks, despite the larger injection volume.
- Glaucoma-related adverse events and IOP increases were infrequent and similar between treatment groups.
- No sustained increases in pre-injection IOP were observed over time with either aflibercept 8 mg or 2 mg.
A pooled analysis of the Phase 3 PULSAR and PHOTON trials found that aflibercept 8 mg, administered at a higher injection volume than aflibercept 2 mg, was not associated with increased long-term intraocular pressure (IOP) or glaucoma-related safety concerns through 96 weeks in patients with neovascular age-related macular degeneration (nAMD) or diabetic macular edema (DME).
The analysis included 1,667 patients, of whom 1,164 received 70 μl injection volume used with aflibercept 8 mg and 503 received the 50 μl volume used with aflibercept 2 mg.
Baseline mean IOP was 15.0 mmHg in the aflibercept 8 mg group and 15.1 mmHg in the aflibercept 2 mg group. Glaucoma-related treatment-emergent adverse events, including increases in IOP, were infrequent and generally similar between treatment arms, with rates of 9 and 6 per 1,000 injections for aflibercept 8 mg and 2 mg, respectively.
Paracentesis rates were 1 event per 1,000 injections reported in the aflibercept 8 mg group and none in the aflibercept 2 mg group. Mean pre-injection IOP measurements remained similar across visits, with no sustained increases observed over time in either treatment group.
Reference
Loewenstein A, Schmidt-Ott U, Do DV, et al. Intraocular Pressure Outcomes with Intravitreal Aflibercept 8 mg: A 96-Week Pooled Analysis from PULSAR and PHOTON. Ophthalmol Ther. 2026;doi: 10.1007/s40123-026-01424-y. Epub ahead of print. PMID: 42287526.
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