Intravitreal VEGF inhibitor use and absorption

Figure: Summary of pharmacokinetic studies showing serum drug levels, serum half-lives from systemically and intravitreally injected VEGF inhibitors. [Drug], concentration of drug every 2 weeks; mg, milligrams; mg/kg, milligram/kilogram; OD, right eye; OU, left eye; q(x) weeks, every (x) weeks; s[Drug], serum concentration of drug; T1/2, half-life (in days). From Shye et.al. CKJ 2020, open access [14].
  • Intravitreal injections of VEGF inhibitors once thought to be far removed from having a systemic effect. have recently been demonstrated to be absorbed at levels high enough to effect intravascular VEGF levels [9].
  • The two most potent agents are bevacizumab and aflibercept, ranibizumab is less highly absorbed [9,14].