Clinical Report: Higher-Volume Injections Don’t Elevate Glaucoma Risk
Overview
A recent study presented at the 2025 ASRS meeting indicates that higher-volume intravitreal injections of aflibercept 8 mg, pegcetacoplan, and avacincaptad pegol do not significantly elevate intraocular pressure (IOP) or increase glaucoma risk in treatment-naïve patients. The findings are based on a comprehensive analysis of real-world data from over 3,700 patients.
Background
The safety of intravitreal injections is a critical concern as the use of higher-volume agents increases. Understanding the impact of these therapies on IOP and glaucoma risk is essential for clinicians to ensure patient safety and optimize treatment outcomes. This study addresses these concerns by analyzing real-world data to provide insights into the long-term effects of newer therapies.
Data Highlights
| Therapy | Mean IOP Change (mmHg) | Glaucoma Incidence |
|---|---|---|
| Aflibercept 8 mg | Stable | No significant increase |
| Pegcetacoplan | Stable | No significant increase |
| Avacincaptad pegol | Stable | No significant increase |
Key Findings
- No significant IOP elevation observed across all treatment groups over 24 months.
- Mean IOP remained within 1 mmHg of baseline for all therapies.
- Statistical analysis showed no increased risk of IOP elevation greater than 5 mmHg for aflibercept 8 mg and avacincaptad pegol.
- Incidence of newly diagnosed glaucoma did not differ significantly between higher-volume agents and control groups.
- Real-world data supports findings from phase 3 clinical trials regarding IOP safety.
Clinical Implications
Clinicians can confidently administer higher-volume intravitreal injections without significant concern for elevated IOP or glaucoma development in treatment-naïve patients. Ongoing monitoring of IOP remains essential, but these findings may alleviate some apprehensions regarding the safety of newer therapies.
Conclusion
The study provides reassuring evidence that higher-volume intravitreal injections do not pose a significant risk for IOP elevation or glaucoma in patients, supporting their use in clinical practice.
References
- Deepak Sambhara, MD, FASRS, Retinal Physician, 2025 -- Higher-Volume Injections Don’t Elevate Glaucoma Risk
- Ophthalmology Management, 2018 -- Avoid injection risks
- Retinal Physician, 2006 -- Managing Intraocular Pressure Elevation Following Intravitreal Steroid Injection
- Ophthalmology | Vol 132, Issue 4, 2025 -- ScienceDirect.com
- ophthalmology management — More Good Than Harm
- Retinal Physician — Complications of Intravitreal Injections
- Clinical Review - Aflibercept 8 mg (0.07 mL) (Eylea HD) - NCBI Bookshelf
- Ophthalmology Management — More Good Than Harm
- Ophthalmology | Vol 132, Issue 4, Pages A1-A20, P1-P344, e1-e78, 375-506 (April 2025) | ScienceDirect.com by Elsevier
- Higher-Volume Injections Don’t Elevate Glaucoma Risk | Retinal Physician
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