aflibercept
Eylea (aflibercept) is a VEGF inhibitor from Bayer that acts as a decoy receptor, trapping vascular endothelial growth factor before it can stimulate abnormal blood vessel growth in the retina. It is injected into the eye to treat neovascular age-related macular degeneration, diabetic macular oedema, macular oedema after retinal vein occlusion, diabetic retinopathy, and retinopathy of prematurity.
This page is based on EMA and FDA prescribing information for aflibercept; the mechanism is explained in plain language, and analogies are used only where they stay accurate.
How it works
Explains what the medicine does in the body, not dosing, side effects, or safety.
An analogy
In a healthy eye, tiny blood vessels feed the retina. But in diseases like wet AMD, the eye sends out distress signals — mainly a protein called VEGF — that trick the body into growing new, leaky vessels where they do not belong. These bleed and swell the retina, blurring vision. Aflibercept works like a molecular sponge: it soaks up those signals before they can reach the vessel wall, so abnormal growth slows down and the retina can dry out.
In simple terms
Aflibercept is an engineered protein that circulates in the eye after an injection. It binds to vascular endothelial growth factor (VEGF-A), VEGF-B, and placental growth factor — three molecules that promote leaky, abnormal blood vessel growth in the retina. By trapping these molecules, aflibercept reduces fluid leakage, swelling, and the formation of new vessels. The result is stabilised or improved vision in conditions such as wet age-related macular degeneration, diabetic macular oedema, and retinal vein occlusion.
In depth
Aflibercept is a recombinant fusion protein consisting of the second immunoglobulin (Ig) domain of VEGF receptor 1 (VEGFR-1) fused to the third Ig domain of VEGFR-2, attached to the Fc portion of human IgG1. This design gives it sub-nanomolar affinity for VEGF-A (including all isoforms), VEGF-B, and placental growth factor (PlGF), exceeding the binding strength of either native receptor alone. By sequestering these ligands, aflibercept prevents them from binding VEGFR-1 and VEGFR-2 on endothelial cells, thereby blocking downstream signalling through PLCγ, PI3K/Akt, and MAPK pathways that drive endothelial proliferation, migration, and vascular permeability. Intravitreal injection delivers the protein directly to the posterior segment, where it reduces central retinal thickness and improves visual acuity in neovascular and oedematous retinal disease.
See it in motion
A schematic animation of the mechanism — simplified for clarity, not drawn to scale.
Aflibercept works like a molecular sponge
- But in diseases like wet AMD, the eye sends out distress signals — mainly a protein called VEGF — that trick the body into growing new, leaky vessels where they do not belong.
- Aflibercept is an engineered protein that circulates in the eye after an injection.
- By trapping these molecules, aflibercept reduces fluid leakage, swelling, and the formation of new vessels.
- The result is stabilised or improved vision in conditions such as wet age-related macular degeneration, diabetic macular oedema, and retinal vein occlusion.
Target: Vascular endothelial growth factor A (VEGF-A)
A signalling protein that stimulates new blood vessel growth; aflibercept acts as a decoy receptor that binds VEGF-A, VEGF-B, and placental growth factor, preventing them from activating their native receptors on endothelial cells.
Approved uses
Approved uses differ by country and change over time. Always follow your local prescribing information.
Approved uses in European Union
EMA- Treatment of neovascular (wet) age-related macular degeneration (AMD) in adults
- Treatment of visual impairment due to diabetic macular oedema (DME) in adults
- Treatment of visual impairment due to macular oedema secondary to retinal vein occlusion (branch, central, and hemiretinal RVO) in adults
- Treatment of visual impairment due to myopic choroidal neovascularisation (myopic CNV) in adults
- Treatment of retinopathy of prematurity (ROP) in preterm infants with zone I, zone II, or aggressive posterior disease
Approved uses in United States
FDA- Neovascular (wet) age-related macular degeneration (AMD)
- Macular edema following retinal vein occlusion (RVO)
- Diabetic macular edema (DME)
- Diabetic retinopathy (DR)
Official sources
The statements on this page trace back to these records.
- Eylea (aflibercept) — Summary of product characteristics and package leaflet, English version
European Medicines Agency
- U.S. Food and Drug Administration: YESAFILI prescribing information
U.S. Food and Drug Administration
- Emc SmPC: Aflibercept (UK licensed product)
Medicines and Healthcare products Regulatory Agency (EMC)
This page explains how the medicine works — it isn’t the patient leaflet. For anything that applies to you, read the leaflet that came with your medicine or ask your pharmacist.
MedUnfold provides educational content and is not medical advice. Always follow your local prescribing information and healthcare professional.