Evaluating Safety and Clinical Confidence between Aflibercept 8 mg and 2 mg in Retinal Vascular Diseases

This segment reviews safety considerations when moving from aflibercept 2 mg to the 8 mg formulation. Panelists emphasize that 8 mg is the same molecule at higher molar dose, with clinical trial and real-world experience showing a safety profile comparable to 2 mg. Practical risks tied to workflow—such as drawing from vials versus using prefilled syringes—are highlighted given implications for endophthalmitis. Systemic safety (e.g., arterial thromboembolic events) remains a key concern, particularly in older adults and people with diabetes who may receive bilateral injections; available data and clinical experience do not suggest increased risk with 8 mg. Rare patient reports of transient post-injection hypertension are noted anecdotally without clear causality. Patient psychology matters: many are reluctant to switch if currently stable. Framing the benefit as fewer injections—with a consequent reduction in cumulative endophthalmitis risk and clinic burden—can facilitate acceptance of longer-acting therapy.