Intravitreal aflibercept use in the treatment of macular edema from central retinal vein occlusion

Aflibercept is a recently US FDA-approved anti-VEGF agent designed for intravitreal injection. Anti-VEGF agents have recently been demonstrated to be potent inhibitors of neovascular growth and vascular permeability in large clinical trials. The majority of studies of anti-VEGF agents are in the setting of age-related macular degeneration, but studies looking at diabetic macular edema and macular edema from central retinal vein occlusion (CRVO) and branch retinal vein occlusion are increasing the scope of utility of anti-VEGF drugs. Aflibercept for single-use intravitreal injection has been approved in the setting of age-related macular degeneration and in macular edema caused by CRVO in the USA (approval has been sought in Europe). The purpose of this review is to examine the use of aflibercept in the setting of CRVO and the role it may potentially play in the expanding indications for anti-VEGF agents.