While short-term use of anti-vascular endothelial growth factor (anti-VEGF) agents appears safe for most patients, those with preexisting kidney disease may be at higher risk of kidney dysfunction, particularly with prolonged treatment.

There is no definitive evidence linking anti-VEGF therapy to major heart problems, but patients with prior cardiovascular disease may face a slightly increased risk of stroke or heart attacks, necessitating close monitoring.

Pregnant women, breastfeeding mothers, and neonates with retinopathy of prematurity require careful evaluation before receiving anti-VEGF therapy, as its systemic effects may impact fetal and infant development.

By synthesizing available literature, our review not only discusses potential systemic risks but also offers practical recommendations on patient selection, monitoring protocols, and risk mitigation strategies. This adds a real-world clinical perspective, helping ophthalmologists and other specialists make informed treatment decisions.