A Prospective Masked Clinical Assessment of Inflammation After Intravitreal Injection of Ranibizumab or Aflibercept.

PURPOSE

To compare anterior chamber and vitreous inflammation after intravitreal injection of ranibizumab or aflibercept.

METHODS

This was a prospective, open label, nonrandomized phase 4 clinical study. One hundred patients with choroidal neovascularization due to age-related macular degeneration received intravitreal aflibercept (N = 53) or ranibizumab (N = 47). Medication use was balanced by gender, injected eye, and lens status (phakic vs. pseudophakic). An examiner masked to medication graded anterior chamber and vitreous inflammation 1-2 and 5-7 days after injection according to the Standardization of Uveitis Nomenclature grading scheme.

RESULTS

Mean patient age was 78.6 years. Maximum anterior chamber reaction of 0.5+ was seen at the first postinjection examination in 2% of eyes receiving ranibizumab and in 19% of eyes receiving aflibercept (Fisher's exact test 2 sided, P = 0.0091); vitreous reaction was minimal and infrequent in both groups and the difference was not statistically significant. At 5-7 days after injection, 1 patient treated with aflibercept had residual anterior chamber inflammation of 0.5+ and no patient treated with ranibizumab had residual inflammation.

CONCLUSION

Aflibercept may be associated with more anterior chamber inflammation than ranibizumab, although mild and transient. This should not be mistaken for endophthalmitis.