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Intravitreal Injections

Intravitreal drug delivery has become a popular method of treatment of many retinal diseases, commonly including AMD, Diabetic Retinopathy, and Retinal Vein Occlusions. The frequency of intravitreal injections has significantly increased since the introduction of Anti-VEGF medications. This is an important procedure that Retina Specialists use on a daily basis, and it is important to master the techniques of effective injections for patient safety and reduction of complications.

Intravitreal is a route of administration of a drug or other substance, in which the substance is delivered into the eye. “Intravitreal” literally means “inside the eye”.  Usually intravitreal administration of drugs is used to treat various conditions of the eye.

 

What is an intravitreal injection?

This is an injection into the vitreous, which is the jelly-like substance inside the eye. It is performed to place medicines inside the eye, near the retina. The medicines may help stop growth of new blood vessels by blocking the effects of growth signals the body sends to generate new blood vessels. These drugs are considered the first-line treatment for all stages of wet macular degeneration.

Medications used to treat wet macular degeneration include:

•Bevacizumab (Avastin)
•Ranibizumab (Lucentis)
•Pegaptanib (Macugen)
•Aflibercept (Eylea)
Intravitreal Injection Procedure
Once your pupil is dilated, the actual procedure takes around 15 minutes. You will lie in a comfortable position and anaesthetic (numbing) drops are placed in your eye. Your eye and eyelids will also be cleaned with an iodine antiseptic solution. The eye is then held open with an instrument and the medicine is injected into your vitreous. You may feel slight pressure on the eye when this is done, but you should not experience pain. After the injection procedure, the doctor will check your eye. Some antibiotic ointment will be placed in your eye before you leave. You may experience a gritty sensation in the eye, and there may be bleeding over the white of the eye. You should not worry about this, it will resolve with time. You might see floaters; however these will become smaller and disappear over a couple weeks. You may undergo repeat injections every few weeks to maintain the beneficial effect of the medicine. In some instances you may partially recover vision as the blood vessels shrink and the fluid under the retina absorbs, allowing retinal cells to regain some function.