November 05, 2025

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Higher Cumulative Anti-VEGF Injections May Worsen Cognitive Health: Study

Cognitive health worsens with higher cumulative anti-Vascular Endothelial Growth Factor Injections injections in Macular Degeneration patients, suggests a study published in the Retina Journal.
After intravitreal injection, anti-vascular endothelial growth factor (VEGF) agents are found in the systemic circulation and can suppress systemic VEGF levels. Neuronal health and cognitive function in the central nervous system have been associated with normal physiological levels of vascular endothelial growth factor (VEGF) expression.
A team of researchers from the U.S.A conducted a study to determine whether there was an association between cumulative anti-vascular endothelial growth factor (VEGF) exposure and cognitive function.
One hundred and seventy-five patients aged sixty-five to eighty-five with the vision of at least 20/50 or better in one eye and a diagnosis of age-related macular degeneration took an iPad-based brain health assessment to determine their risk of mild cognitive impairment. The result for each patient was compared with the total number of anti-vascular endothelial growth factor (VEGF) injections per individual patient. Patients were then stratified into groups with 0 injections (control), 1 to 9 injections, ten to twenty injections, or greater than 20 injections.
The results of the study are as follows:
The group of patients with more than twenty injections had a higher likelihood of mild cognitive impairment compared with the control group, with statistically significant worse mean Z-scores.
Thus, the researchers concluded that worsening cognitive health with higher cumulative anti-vascular endothelial growth factor (VEGF) injections. This study was not designed to show a causal link but does suggest that additional investigation is required to demonstrate a causal link between intravitreal therapy and cognitive changes.
Reference:
A study titled, "Brain Health Assessment In Macular Degeneration Patients Undergoing Intravitreal Anti–Vascular Endothelial Growth Factor Injections (The Bham Study): An Interim Analysis" by Ray, Subhransu K. and Manz, Sarah N. published in the Retina Journal.
DOI: 10.1097/IAE.0000000000003066

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