title: Systemic effects of intravitreal vascular endothelial growth factor inhibitors.
abstract: OBJECTIVE
  The development of vascular endothelial growth factor (VEGF) inhibitors has revolutionized the treatment of retinal diseases. However, VEGF functions in many physiological and pathological processes. Consequently, inhibition of this signalling molecule carries the potential to cause serious adverse events.
  
  
  RESULTS
  Numerous clinical trials, meta-analyses and population-based studies have provided data regarding the safety of intravitreal VEGF inhibitor injections. Although individual trials and some meta-analyses have not found significant risks, other meta-analyses have suggested possible risks, especially in patients with multiple baseline risk factors. Population-based studies have not found increased risks of vascular adverse events.
  
  
  CONCLUSIONS
  Overall, results across studies with differing methodologies provide some reassurance that the widespread use of intravitreal injections of VEGF inhibitors has not resulted in significant increases in the risks of adverse events. However, ongoing vigilance and further study remain priorities, with a particular need for greater evaluation of high-risk subgroups. Rapidly evolving treatment options for ocular diseases including new drugs and new delivery technologies will require ongoing evaluations of safety.
authors.affiliation: Department of Ophthalmology, Queen's University, Kingston, Ontario, Canada. rob.campbell@queensu.ca
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Campbell
authors.forename: Chaim M
authors.initials: CM
authors.lastname: Bell
authors.forename: Erica de L P
authors.initials: Ede L
authors.lastname: Campbell
authors.forename: Sudeep S
authors.initials: SS
authors.lastname: Gill
mesh_terms: D020533:Angiogenesis Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D064420:Drug-Related Side Effects and Adverse Reactions; D006801:Humans; D058449:Intravitreal Injections; D012164:Retinal Diseases / Q000139:chemically induced / Q000188:drug therapy*; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors*
chemical_list: D020533:Angiogenesis Inhibitors; D042461:Vascular Endothelial Growth Factor A