Aflibercept 2mg/0.05mL Intravitreal Injection (Eylea)

How it works

It acts as a soluble decoy receptor that binds VEGF-A, VEGF-B and placental growth factor, preventing their interaction with native receptors and thereby reducing pathological retinal vascular leakage and neovascularisation.

Prescribing in practice

• Endophthalmitis is the most serious risk of intravitreal injection, so administer under strict aseptic technique and warn patients to report eye pain, increasing redness or vision loss urgently.
• Measure and manage intraocular pressure, as transient rises can occur after injection.
• Avoid in patients with active ocular or periocular infection or active intraocular inflammation.

Monitoring

Monitor visual acuity, intraocular pressure and the retina (including optical coherence tomography) before and after injections to guide ongoing treatment.

Counselling the patient

• Seek urgent ophthalmic review for new eye pain, marked redness, increased floaters or sudden reduced vision after an injection.
• Do not drive until vision has recovered after the procedure.
• Attend all scheduled injection and review appointments, as treatment is given on an ongoing basis.

Evidence & guidelines

NICE recommends aflibercept across several retinal vascular indications, supported by the VIEW trials in neovascular AMD.