Aflibercept inhibits the binding and activation of the VEGF family and natural VEGFR by specifically blocking VEGF-A and most proangiogenic cytokines, thereby inhibiting division and proliferation of ECs, reducing vascular permeability, and is commonly used in non-neoplastic angiogenic disease like AMD, DR, and DME.380,391 Ziv-aflibercept is an adaptive variant of aflibercept, which has lower pH and higher osmolality (Table 1). Here, VEGFA is linked to age-related macular degeneration.