To the Editor We have read the article by Ngo Ntjam et al,1 in which the authors carried out a systematic review and meta-analysis to analyze major adverse cardiovascular events (MACEs) associated with anti–vascular endothelial growth factor (VEGF) injections. Only randomized clinical trials were included in the analysis, and the study concluded that intravitreal anti-VEGF treatment was not associated with an increase in MACEs.