Eylea (aflibercept) is a prescription medication from Regeneron Pharmaceuticals. This injectable medicine treats diseases affecting the retina, the light-sensitive tissue at the back of the eye. It works to slow disease progression and help preserve eyesight.
Conditions Treated by Eylea
Eylea is approved by the U.S. Food and Drug Administration (FDA) to treat several eye conditions that can lead to vision impairment. One such condition is wet age-related macular degeneration (wet AMD), which occurs when abnormal, fragile blood vessels grow beneath the macula, the central part of the retina. These vessels can leak blood and fluid, causing blurred central vision, dark spots, or wavy lines, and can lead to significant vision loss if untreated.
Diabetic macular edema (DME) is another condition Eylea addresses in individuals with diabetes. Fluid leaks from damaged blood vessels into the macula, causing swelling and leading to blurry vision, distorted lines, or dulled colors. This can severely impact central vision.
Eylea also treats macular edema following retinal vein occlusion (RVO), including central (CRVO) and branch (BRVO) types. RVO occurs when a retinal vein blocks, causing blood and fluid to leak into the retina, particularly the macula. This results in macular swelling, which can manifest as blurred central vision, wavy lines, or blind spots.
Finally, Eylea is approved for diabetic retinopathy (DR), a diabetes complication that damages retinal blood vessels. In advanced stages, DR can cause new, fragile blood vessels to grow and leak, affecting both central and peripheral vision, and potentially leading to floaters or blurriness.
The Anti-VEGF Mechanism of Action
Eylea functions as an anti-vascular endothelial growth factor (anti-VEGF) therapy, targeting proteins in the eye that contribute to retinal diseases. Vascular endothelial growth factor (VEGF) is a protein that, in excessive amounts, promotes the formation of new, abnormal blood vessels and increases the permeability of existing ones. These newly formed vessels are often fragile and prone to leaking blood and fluid into the retina.
Eylea, a recombinant fusion protein, acts like a “decoy receptor” for VEGF. It binds to VEGF-A and placental growth factor (PlGF), two growth factors that drive abnormal blood vessel growth and leakage. By binding to these factors, Eylea prevents them from attaching to their natural receptors on endothelial cells.
This neutralizes excess VEGF and PlGF, inhibiting the growth of new, leaky blood vessels and reducing fluid accumulation in the retina. This results in decreased swelling and prevention of further damage to the macula, helping to preserve and, in some cases, improve vision. This comprehensive blocking of both VEGF and PlGF provides a broad approach to managing the underlying causes of these vision-threatening conditions.
The Eylea Injection Procedure
Eylea injections are outpatient procedures performed by a retina specialist. Before the injection, the eye is prepared for patient comfort and to minimize infection risk. Anesthetic eye drops numb the eye’s surface, ensuring the procedure is typically not painful.
The area around the eye is thoroughly cleaned with an antiseptic solution to prevent infection. An eyelid speculum is gently used to hold the eyelids open, keeping the eye still and exposed for the injection.
Eylea is then injected directly into the vitreous, the jelly-like substance in the center of the eye, using a very thin needle. Patients typically do not see the needle during this quick process.
After the injection, the eye may be rinsed. Immediately following the procedure, vision may be temporarily blurry, and it is advisable to have someone drive you home. Some patients may experience a brief increase in eye pressure within an hour, which is usually monitored by the doctor. Sunglasses can help if the eyes feel sensitive to light.
Potential Side Effects and Risks
Eylea can cause side effects. Common, less severe side effects that typically resolve within a few days include mild eye pain or discomfort, a sensation of something in the eye, temporary blurred vision, eye redness or bleeding on the white part of the eye (conjunctival hemorrhage), and small dark spots or squiggly lines in their vision (floaters).
More serious complications, though rare, can occur following an Eylea injection. One significant risk is endophthalmitis, a severe eye infection that can lead to vision loss if not treated promptly. Symptoms include severe eye pain, worsening redness, increased light sensitivity, and decreased vision.
Another rare but serious risk is retinal detachment, where the retina separates from the back of the eye. This can cause sudden vision changes, flashes of light, or a significant increase in floaters. A notable increase in eye pressure, which can potentially lead to glaucoma or optic nerve damage, has also been reported. Patients should immediately contact their doctor if they experience severe or worsening eye pain, significant changes in vision, or any signs of infection after the injection.