Q&A: Jay Chhablani discusses analysis of retinal vasculitis events with intravitreal agents

Jay Chhablani, MD, a retina specialist from the University of Pittsburgh and vice chair for clinical trials at UPMC Vision Institute, presented a comprehensive study analyzing the FDA Adverse Event Reporting System (FAERS) database focusing on retinal vasculitis associated adverse events at the American Academy of Ophthalmology (AAO) meeting. In an interview, he shared some key takeaways from this research and what retina specialists should know about these events.

Note: The following conversation has been lightly edited for clarity.

Ophthalmology Times Europe: What trends or key findings did your analysis of the FAERS database reveal regarding retinal vasculitis events associated with intravitreal agents?

Jay Chhablani, MD: The [FDA Adverse Event Reporting System] FAERS database, which we analyzed, was very much focused towards the retinal vasculitis associated adverse events. So in this study, we looked into the all the intravitreal agents, including anti-VEGF, as well as complement inhibitors. We included the data from 2010 till 2025 and we noticed that there was a sudden increase in the report of retinal vasculitis in 2020, primarily because of Beovu. And then there was another spike due to Syfovre. However, these reports started coming down as the years passed. We stopped using Wave ou but we got a lot of confidence in Syfovre. And since, since October 2024 the last case of retinal vasculitis, which was reported due to Syfovre, that was the last case. And after that, there have been no events. So we did notice that there was a decrease in the reporting of these events. However, we have to remember that these are absolute numbers. We cannot calculate the rate because we do not have the denominator. One very critical finding, which we notice, is that the number of overall reporting increased after 2020 and I believe this probably happened because of the incidence due to Beovu because we started looking for these side effects more carefully, and then there were lot of reports with other injections as well. And I think that what I learned one more thing out of this study is that there are these side effects associated with all anti-VEGF as well as with all complement inhibitors.

OTE: How do the incidence and severity of these events compare across different IVTs, and what implications does this have for clinical practice?

Chhablani: So this study clearly shows the importance of this database. So my message to all the retina specialists is that, you know, we have such a great portal which allows us to have a bias-free reporting of these events. So we should use it. However, there are many limitations of this database, primarily because...this is kind of a reporting from the provider, the pharma companies. However, there is no verification, and this could still be just the tip of the iceberg. There are many events which we are not reporting. So I think that using this database will certainly establish a strong evidence for many of these adverse events and a great database to study and compare with other conditions as well.

OTE: Based on your findings, what strategies or monitoring protocols would you recommend to minimize the risk of retinal vasculitis in patients receiving IVTs?

Chhablani: I would say that, you know, these are the side effects which are almost not in our control. So sometimes they are drug related, sometimes they are like, could be procedure related. And I think that what we learned with Beovu, that you know this was probably related to the drug. That's why we stopped using it. With Syfovre, the company investigated very significantly and spent a lot of time in understanding the reasons. We believed that you know this could be related to the needle, which they changed it. And since then, we have not seen any side effects due to Syfovre. And I have been using both complement inhibitors very confidently, and I have not seen any side effects in my patients.