4-week Eylea HD improves vision, retinal thickness in wAMD, DME | ASRS 2026

Patients with either wet age-related macular degeneration (AMD) or diabetic macular edema (DME) who were treated with Eylea HD (aflibercept) 8 mg experienced functional and anatomical improvements when treated every four weeks in a real-world trial, according to data presented at the annual meeting of the American Society of Retina Specialists (ASRS) being held July 16 through July 18, 2026, in Montreal.

Developed by Regeneron and Bayer AG, Eylea HD is approved for patients with neovascular (wet) age-related macular degeneration, macular edema and retinal vein occlusion. In the clinical trials, including PULSAR for wAMD and PHOTON for DME, Eylea HD had achieved comparable efficacy and safety results as Eylea 2 mg every eight weeks. (Eylea HD is 8 mg of aflibercept.)

But the efficacy and safety of monthly dosing of Eylea HD has not been extensively studied, Eric W. Schneider, M.D., a vitreoretinal specialist at Tennessee Retina, said during a session at ASRS.

“In PULSAR and PHOTON, patients did relatively well with a minimum of eight weeks between Intravitreal injections,” he said. “There are certainly patients that need more frequent therapy. A lot of the patients that we enrolled in ELARA were patients who were performing suboptimally on aflibercept 8 mg every seven or eight weeks.”

Schneider mentioned one patient in his practice who had been treated every two weeks for several years with Eylea 2 mg but has now been able to have injections every four weeks with Eylea HD.

He said that having increased flexibility in the timing of injections would be helpful for treating patients who were not seeing improvement, but panelists agreed that the number of patients who are unresponsive to Eylea HD is small.

Eylea HD is being evaluated in a real-world trial, ELARA, which is an ongoing open-label study of previously treated patients with age-related macular degeneration or macular edema. The study has enrolled 1,100 patients who had received at least three prior antigen injections in the five months prior to enrollment. Patients received Eylea HD through week 24. After that, patients will have their treatment regimen modified based on prespecified criteria, either shortened or extended by one week, through week 96.

Schneider presented efficacy and safety results from 24 weeks of Eylea HD every four weeks. In the wet AMD cohort, the mean best corrected visual acuity (BCVA) gain was 2.5 letters at week 24, with 32.9% of patients gaining at least five letters and a mean central subfield thickness (CST) reduction of 27.1 microns. The CST is a key measurement of retinal thickness.

In the macular edema cohort, mean best corrected visual acuity gain was 3.2 letters at week 24, with 36.8% of patients gaining at least five letters and a mean CST reduction of 39.7 microns.

Treatment-related adverse events were experienced by 17% of patients with wAMD and 22.3% of patients with DME. Common treatment-related effects were conjunctival hemorrhage, cataract, and vitreous floaters.

“The safety profile of the eight milligram aflibercept monthly is consistent with the established safety profile seen in previous clinical trials with aflibercept two and eight milligrams,” Schneider said.