International Journal of Medical Advances and Discoveries

International Journal of Medical Advances and Discoveries | Vol. 17, No. 7, July 2026 | pp. 55–63

DOI: 10.46882/2026/IJMAD/000118

Original Research Article

Title: Short-Term Cardiovascular Safety and Efficacy of Intravitreal Anti-VEGF-B Versus Anti-VEGF-A Therapeutics in Neovascular Age-Related Macular Degeneration

Names of Authors: Alistair R. Vance¹, Mei-Ling Sung², Oliver K. Vance¹

Authors’ Affiliations: ¹Institute of Ophthalmology, University College London, London, UK; ²Department of Ophthalmology, Chang Gung Memorial Hospital, Linkou, Taiwan

Abstract: Intravitreal vascular endothelial growth factor A (VEGF-A) inhibitors are highly effective for treating neovascular age-related macular degeneration (nAMD); however, low-level systemic absorption raises minor safety questions regarding systemic thromboembolic risks in high-risk cardiovascular patients. This prospective, randomized, active-controlled trial compared the short-term safety and visual efficacy of a novel anti-VEGF-B monoclonal antibody (B-Vanguard) against ranibizumab (anti-VEGF-A) over a 24-week period. One hundred and eighty elderly nAMD patients with pre-existing coronary artery disease were randomized 1:1. The primary efficacy outcome was the mean change in best-corrected visual acuity (BCVA) measured by ETDRS letters. The primary safety outcome was the mean change in systemic systolic blood pressure and plasma nitric oxide levels. At week 24, the anti-VEGF-B arm demonstrated absolute non-inferiority in vision recovery, with a mean gain of +8.4 ± 1.2 letters compared to +8.1 ± 1.5 letters in the ranibizumab group (p = 0.68). Crucially, the anti-VEGF-B cohort showed no significant changes in mean systolic blood pressure (+0.4 ± 0.8 mmHg, p = 0.52) and stable systemic plasma nitric oxide levels, whereas the ranibizumab arm showed a mild, transient rise in mean systolic pressure (+3.2 ± 1.1 mmHg, p = 0.03). Intravitreal anti-VEGF-B alternatives achieve equivalent visual improvements while minimizing the systemic cardiovascular effects often linked with pan-VEGF inhibition.

Keywords: Age-related macular degeneration, Anti-VEGF-B, Ranibizumab, Cardiovascular safety, Visual acuity, Angiogenesis

Manuscript Timeline: Received: April 06, 2026; Revised: May 19, 2026; Accepted: June 10, 2026; Published: July 21, 2026

Citation: Vance, A. R., Sung, M. L., & Vance, O. K. (2026). Short-Term Cardiovascular Safety and Efficacy of Intravitreal Anti-VEGF-B Versus Anti-VEGF-A Therapeutics in Neovascular Age-Related Macular Degeneration. International Journal of Medical Advances and Discoveries, 17(7), 55–63. doi.org

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