Anti-VEGF Injections Safe Around Cardiovascular Events, finds study

A new study published in the Journal of the American Medical Association found that administration of anti–vascular endothelial growth factor (anti-VEGF) eye injections around the time of stroke or myocardial infarction (MI) was not associated with increased mortality or major complications, and outcomes were similar across commonly used anti-VEGF agents.

Intravitreal anti-VEGF therapies are widely used to treat retinal diseases such as age-related macular degeneration (AMD) and diabetic retinopathy. However, when patients experience a stroke or MI, physicians often face uncertainty about whether to pause or modify these treatments due to potential systemic risks.

Thus, this research analyzed deidentified electronic health records from a multicenter network from 2005 to 2025. The study focused on patients who had already been receiving anti-VEGF therapy for at least 3 months before experiencing a cardiovascular event. They compared outcomes between those who continued receiving injections shortly before or after the event, within a “peri-CVE” window, and those who temporarily stopped treatment.

After careful matching of patient characteristics using propensity score methods, this study included more than 3,000 matched pairs across stroke and heart attack groups. 

Among stroke patients, those who received anti-VEGF injections during the peri-event period had significantly lower mortality rates at both 3 months and one year when compared to those who did not. They also experienced fewer neurological deficits at 3 months, though this benefit was not statistically significant at one year.

Also, the patients recovering from MI who continued anti-VEGF therapy showed lower mortality at both time points. They also had a reduced risk of developing heart failure at 3 months, although this difference diminished by the one-year mark.

When this research narrowed the timing of injections to those administered strictly within 14 days before the cardiovascular event, the mortality benefits remained consistent. However, differences in functional outcomes like neurological deficits and heart failure, were less pronounced under these stricter conditions.

The study also examined whether outcomes varied depending on the specific anti-VEGF drug used, including commonly prescribed agents like aflibercept, bevacizumab, and ranibizumab. No meaningful differences were found among these medications, which highlighted that the observed safety profile applies broadly across treatment options.

Overall, the findings challenge concerns that continuing anti-VEGF therapy during the peri-event period might worsen systemic outcomes. Overall, the findings of this study suggest that avoiding unnecessary interruptions in therapy could have significant quality-of-life implications for patients at risk of vision loss.

Source:

Bordbar, D. D., Mukhtar, A. O., Loya, A., Alsoudi, A. F., Muayad, J., Chauhan, M. Z., Patel, N. A., Sallam, A. B., & Weng, C. Y. (2026). Peri-event intravitreal anti-VEGF and systemic outcomes after stroke or myocardial infarction. JAMA Ophthalmology. https://doi.org/10.1001/jamaophthalmol.2026.0460