Anti-VEGF injections for macular disease

Anti-VEGF treatment involves an injection of medication into the clear, jelly-like substance inside the eye, called the vitreous. Anti-VEGF injections are given to treat certain macular conditions that cause abnormal blood vessel growth and/or fluid leakage affecting the retina.

Macular conditions treated with anti-VEGF injections include:

  • Neovascular (wet) age-related macular degeneration (AMD)
  • Diabetic macular edema (DME)
  • Retinal vein occlusion (RVO)
  • Myopic macular degeneration
  • Any other macular condition that causes new blood vessel formation and leakage of fluid under the retina

 

Are anti-VEGF injections an effective treatment?

Repeated anti-VEGF treatment is highly effective at stabilising and maintaining best functional vision for as long as possible. The aim is to stop the growth of abnormal blood vessels and fluid leakage. The vast majority of people who receive anti-VEGF injections maintain better vision over an extended period compared to people who are not treated. It is important to note that early detection and treatment produces the best outcomes.

 

What is involved in the procedure?

Anti-VEGF injections are performed using a very fine needle. A small eyelid speculum (medical instrument) is used to keep the eyelids open. Local anaesthetic is applied first to numb the eye. Antiseptic is used to prevent infection. Minimal discomfort is to be expected, but injections should not be painful. Treatment is performed by an ophthalmologist.

 

Are there any restrictions after having anti-VEGF injections?

There are no major restrictions. You should not drive on the day of your procedure. You should also avoid getting any water into your eye for the first few days after your injection. There are generally no travel restrictions. You should seek the advice of your ophthalmologist about what you should or should not do after having an anti-VEGF injection.

 

How often is anti-VEGF treatment required?

For most people, treatment usually begins with injections at monthly intervals. Treatment is determined by the response of each patient. Depending on the response, the interval between injections may be extended. For most patients, ongoing or indefinite treatment is required. The interval between injections typically ranges from four to 12 weeks.

 

When would anti-VEGF treatment not be given?

Anti-VEGF injections may not be given if you have any of the following:

  • Eye infection (inside or around either eye)
  • Pregnancy – whether trying to fall pregnant or already pregnant

It is important to tell your ophthalmologist about your medical history, any conditions you have, what medications you are taking and whether you have any allergies to medications.

 

Are there any side effects of anti-VEGF treatment?

You may notice any of the following after an injection:

  • Sore eyes or a gritty sensation lasting for a few days after the injection 
  • Small floaters in your vision, which might be seen for up to a few days after the injection
  • Redness (blood) on the white part of the eye (conjunctiva) where the needle enters. This usually resolves within one to two weeks

 

Are there any risks associated with anti-VEGF treatment?

The major risks of injecting medication into the eye include the following:

  • Increased pressure inside the eye
  • Inflammation inside the eye
  • Infection inside the eye
  • Bleeding inside the eye
  • Retinal tear or detachment

These risks are very rare, and vision loss due to the treatment is uncommon.

Your ophthalmologist will discuss with you the benefits and risks of treatment and provide instructions regarding after care.

If after having an anti-VEGF injection, your eyes become increasingly red, swollen, painful or sensitive to light, or if there are any sudden changes to your vision, contact your ophthalmologist as soon as possible.

Macular Disease Foundation Australia exists to provide information and support for people with macular disease, their families and carers. Our National Helpline can provide you with further information about your condition including treatment, and can advise you on the various supports and services available: 1800 111 709.