Long-Term Side Effects of Eylea Injections

When it comes to treatments for retinal conditions like age-related macular degeneration (AMD) or diabetic macular edema (DME), injections like Eylea (aflibercept) have transformed patient care. Although these anti-VEGF injections effectively help preserve vision by preventing abnormal blood vessels from leaking, concerns about potential long-term side effects often linger—especially for patients undergoing repeated treatments.

While Eylea injections are generally considered safe and effective, some patients and practitioners express concerns about ongoing risks, including potential optic nerve damage, the need for further medical interventions, and overall eye health with prolonged use.

This article explores the possible long-term side effects associated with Eylea (aflibercept), helping patients better understand these risks and how to manage them effectively when considering sustained anti-VEGF treatments.

Key Takeaways

• Eylea inhibits vascular endothelial growth factor (VEGF) to prevent abnormal blood vessel growth and leakage in the retina. It requires injections every 4–12 weeks for vision stability.
• Some systemic effects may arise due to minimal drug absorption into the bloodstream, including increased blood pressure and risks for individuals with cardiovascular conditions.
• Regular eye exams, OCTs, IOP checks, and cardiovascular evaluations are vital for detecting and managing potential complications.
• Patients should be informed about treatment frequency, potential side effects, and the importance of reporting any concerning symptoms to their healthcare provider.
• Eylea is a valuable treatment for chronic retinal diseases, but awareness of long-term side effects and proactive monitoring are essential for patient safety and treatment efficacy.

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Overview of Long-Term Use in Retinal Diseases

Eylea works by blocking vascular endothelial growth factor (VEGF), a substance responsible for abnormal growth and leakage of blood vessels in the retina. To maintain stable vision, many patients require regular injections, typically every 4–12 weeks.

Benefits of Long-Term Eylea Use

• Prevents disease progression and severe vision loss.
• Maintains retinal health by controlling fluid buildup.
• Reduces the need for more invasive procedures like laser surgery.

Challenges of Long-Term Use

• Increased risk of ocular and systemic side effects.
• Potential treatment resistance in some patients.
• Need for frequent monitoring and adjustments in treatment plans.

Despite these challenges, Eylea remains an essential treatment for chronic retinal conditions, allowing many patients to maintain or even improve their vision long-term.

Potential Ocular Long-Term Side Effects

While most patients tolerate Eylea well, repeated injections over time can occasionally lead to complications affecting eye health.

Common Ocular Side Effects

• Increased Intraocular Pressure (IOP): Some patients experience a temporary or persistent elevation in eye pressure, increasing their risk of developing glaucoma.
• Inflammation (Uveitis): Frequent injections may trigger mild to moderate inflammation inside the eye, often requiring additional anti-inflammatory treatments.
• Floaters: Injection-related debris or small air bubbles may cause visual disturbances, known as floaters.

Serious Ocular Complications

• Retinal Tears or Detachment: Although rare, repeated injections may weaken retinal tissue, slightly elevating the risk of retinal detachment.
• Endophthalmitis: A severe, albeit uncommon, infection that can rapidly lead to significant vision loss without prompt medical intervention.
  Cataract Formation: Frequent injections can accelerate cataract progression, especially in older adults.

To minimize these risks, ophthalmologists closely monitor patients’ eye health and may adjust treatment schedules as needed.

Systemic Long-Term Side Effects

Eylea primarily targets the eye, but small amounts may enter the bloodstream, posing potential systemic risks. Many patients wonder, “how long does Eylea stay in your system?“ Typically, Eylea leaves the bloodstream within days after an injection, but even this brief presence can carry minor systemic risks.

Patients with existing cardiovascular conditions should exercise caution. In rare cases, high-risk individuals may experience a slight increase in the risk of stroke or heart attack, and some may notice elevated blood pressure. Additionally, the inhibition of VEGF by Eylea may slow the body’s natural wound healing process.

Though systemic risks remain low, doctors carefully evaluate each patient’s medical history to minimize potential complications and ensure the safest treatment approach.

Monitoring Strategies for Long-Term Patients

Regular monitoring is essential to identify and manage any complications associated with long-term Eylea use.

Recommended Monitoring Strategies

• Routine Eye Exams: Regular checks for signs of inflammation, changes in intraocular pressure (IOP), or retinal damage.
• Optical Coherence Tomography (OCT): Regular OCT scans track fluid accumulation and retinal thickness, helping to determine how effectively the treatment is working.
• Intraocular Pressure Checks: Periodic measurements help prevent damage linked to glaucoma.
• Cardiovascular Evaluations: Patients with existing heart conditions may need periodic cardiovascular assessments to ensure continued safety during treatment.

By following a structured monitoring plan, doctors can make timely adjustments to treatment, keeping risks to a minimum

Patient Education and Informed Consent

Educating patients about the potential long-term side effects of Eylea injections helps them make well-informed decisions about their treatment. Ophthalmologists should clearly explain why ongoing injections might be necessary, outline possible risks, and discuss alternative treatments. Patients should also be taught to recognize critical warning signs, such as severe eye pain or sudden changes in vision, and to report these immediately. 

When patients fully understand their treatment, they’re more likely to adhere closely to the recommended plan and promptly seek medical attention if problems occur.

It’s important for patients to understand the commitment involved with long-term Eylea treatment, as maintaining stable vision typically requires regular injections. Knowing and recognizing the importance of consistently following the injection schedule encourages better outcomes. 

If side effects become troublesome, doctors can adjust treatment plans or explore alternative therapies, balancing effectiveness with patient comfort and overall quality of life.

Conclusion

Eylea remains an important treatment option for managing chronic retinal diseases, yet it’s essential not to overlook the potential long-term side effects of repeated injections. While most patients handle the treatment well, careful monitoring for both ocular and systemic complications is crucial.

By scheduling regular check-ups, educating patients clearly, and developing individualized treatment plans, doctors can maximize Eylea’s benefits and effectively reduce associated risks—helping patients maintain healthy vision for years to come.

FAQs

1. Can Eylea cause permanent eye damage?

Serious complications, such as retinal detachment or endophthalmitis, are rare but can lead to vision loss if untreated. Regular monitoring helps detect and manage these risks early.

2. Are there alternative treatments for Eylea?

Yes, alternatives include Lucentis (ranibizumab), Avastin (bevacizumab), and Beovu (brolucizumab). Each option has unique benefits, and the best choice depends on individual patient needs.

3. Can I stop Eylea injections if my vision improves?

Stopping treatment without medical supervision can lead to disease recurrence. Always consult your ophthalmologist before making changes to your treatment plan.

References

Retinal Physician. Complications of Intravitreal Injections. Retinal Physician. April 2022. Accessed March 20, 2025. https://retinalphysician.com/issues/2022/april/complications-of-intravitreal-injections/..

OncoDaily. Ocular Side Effects of Anti-VEGF Therapy. OncoDaily. Accessed March 20, 2025. https://oncodaily.com/oncolibrary/ocular-side-effects-of-anti-vegf-therapy..