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Anti-VEGF agent (intravitreal) Pregnancy: Avoid — theoretical risk; contraception required during treatment.

Aflibercept 2mg/0.05mL Intravitreal Injection (Eylea)

Brand names: Eylea

Adult dose

Dose: 2 mg (0.05 mL) by intravitreal injection
Route: Intravitreal injection (specialist procedure)
Frequency: Monthly for 3 months (loading), then every 2 months (wet AMD); individualised for DMO/RVO
Max: 2 mg per injection per eye
Wet (neovascular) AMD: 2 mg monthly for 3 consecutive months, then 2 mg every 2 months. Diabetic macular oedema (DMO): 2 mg monthly for 5 injections, then every 2 months. Central retinal vein occlusion (CRVO): 2 mg monthly. Branch RVO: 2 mg monthly as needed. Administered under aseptic conditions by trained ophthalmologist only.

Paediatric dose

Route: Intravitreal
Frequency: Not applicable
Max: Not indicated in paediatric patients
Not licensed or indicated in paediatric patients.

Dose adjustments

Renal

No dose adjustment required.

Hepatic

No dose adjustment required.

Clinical pearls

  • NICE-approved for wet AMD, DMO, and RVO — check current NICE TA for eligibility criteria
  • Treat-and-extend (T&E) protocol now standard — extends intervals based on disease activity (OCT-guided)
  • Superior to monthly ranibizumab in some studies for large lesions (VIEW studies)
  • Post-injection: patient should report any sudden vision change, eye pain, or increased redness immediately (endophthalmitis symptoms)
  • Higher dose (8 mg, Eylea HD) now also available — reduces injection burden in suitable patients

Contraindications

  • Active or suspected ocular or periocular infection
  • Active severe intraocular inflammation
  • Hypersensitivity to aflibercept
  • Previous history of rhegmatogenous retinal detachment

Side effects

  • Conjunctival haemorrhage (common post-injection)
  • Eye pain and foreign body sensation
  • Vitreous floaters (post-injection)
  • Endophthalmitis (rare but serious — 0.04% per injection)
  • Raised IOP (transient post-injection)
  • Retinal detachment (rare)
  • Systemic arterial thromboembolic events (rare — anti-VEGF class effect)

Interactions

  • Systemic anti-VEGF agents — additive systemic VEGF suppression

Monitoring

  • Visual acuity at each visit
  • OCT (macular thickness)
  • IOP pre and post injection
  • Signs of infection

Reference: BNFc; BNF; NICE TA294 (wet AMD); NICE TA509 (DMO); Eylea SPC. Verify against your local formulary and the latest BNF before prescribing.

Related

Curated clinical cross-links plus same-class fallbacks.

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