Intravitreal anti-VEGF injections for neovascular age-related macular degeneration are associated with a small but increased risk of stroke or transient ischemic attack (TIA), particularly within the first 60 days after treatment, according to a study.
The analysis, which included over 33,000 patients treated, found that 2.9% of patients experienced a stroke or TIA within 90 days of receiving injections with ranibizumab, aflibercept, or bevacizumab.
Researchers cross-referenced data from the Swedish Macula Register and the national stroke registry, identifying 936 stroke/TIA events within 90 days of anti-VEGF treatment. Compared to non-users, treated patients had a 27% increased risk (RR 1.27, 95% CI 1.22–1.33), with the highest relative risk occurring within the first 60 days.
The researchers concluded that “an assessment of high-risk populations and risk-benefit weighting is necessary before intravitreal anti-VEGF injections are considered.”
Reference
Falemban AH, Söderberg-Löfdal K, Jonsson F, et al. Intravitreal anti-vascular endothelial growth factor injections and risks of stroke in patients with neovascular age-related macular degeneration-A registry-based cohort study. Acta Ophthalmol. 2025;doi: 10.1111/aos.17534. Epub ahead of print. PMID: 40481786.
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