The Efficacy and Safety of Intravitreal Aflibercept 8 mg in Clinical Practice

<b>Purpose:</b> To characterize real-world use of intravitreal aflibercept 8 mg across 22 US retina practices. <b>Methods:</b> Retrospective review of patients who received at least 1 intravitreal aflibercept 8 mg injection for treatment of neovascular age-related macular degeneration, diabetic macular edema, or diabetic retinopathy through April 1, 2024. Data from health records were collected retrospectively, including best-corrected visual acuity (BCVA), interval between treatments, and adverse events. <b>Results:</b> A total of 8323 eyes of 6271 patients received 20 385 intravitreal aflibercept 8 mg injections. A total of 669 eyes (8.0%) were not previously treated. Among treatment-naive eyes, mean logMAR BCVA improved from 0.57 (Snellen equivalent ~20/80) at the time of the first intravitreal aflibercept 8 mg injection, to 0.47 (Snellen equivalent ~20/60) (<i>P</i> < .001), 0.46 (Snellen equivalent ~20/60) (<i>P</i> < .001), and 0.48 (Snellen equivalent ~20/60) (<i>P</i> = .012) at the second, third, and fourth intravitreal aflibercept 8 mg injections, respectively. Among previously treated eyes, mean logMAR BCVA improved from 0.46 (Snellen equivalent ~20/60) at the time of the first intravitreal aflibercept 8 mg injection, to 0.42 (Snellen equivalent ~20/50) (<i>P</i> < .001), 0.43 (Snellen equivalent ~20/50) (<i>P</i> < .001), and 0.45 (Snellen equivalent ~20/60) (<i>P</i> = .70) at the second, third, and fourth intravitreal aflibercept 8 mg injections, respectively. Treatment intervals to time of second, third, and fourth intravitreal aflibercept 8 mg injections increased compared to baseline intervals, by a mean of 2.2 days (<i>P</i> < .001), 2.5 days (<i>P</i> < .001), and 13.5 days (<i>P</i> < .001), respectively. Intraocular inflammation was observed in 11 eyes (1 in 1853 injections). Nine eyes (1 in 2265 injections) developed suspected endophthalmitis. <b>Conclusions:</b> In this real-world clinical setting, intravitreal aflibercept 8 mg treatment demonstrated improvements in BCVA outcomes, with increased intervals between injections. Rates of intraocular inflammation and endophthalmitis were low.