An anti-VEGF injection is for the treatment for maculopathy and can stablise and help rapidly improve vision.
Vascular endothelial growth factor (VEGF) is a protein produced by the retina that stimulates the growth of new blood vessels. It is part of the system that restores the oxygen supply to tissues when blood circulation is inadequate. It is activated when blood vessels are blocked due to high blood glucose levels.
In recent years new treatments, called anti-VEGFs, have been developed to bind to and inhibit VEGF.
Lucentis, made by Novartis, is currently the only anti-VEGF ophthalmic treatment licensed for use in patients with maculopathy in the UK. The intra-ocular treatment is injected directly into the eye and helps to reduce the leakage of fluids into the macular.
Avastin, made by Roche, is another anti-VEGF but is approved as a treatment for colon and rectal cancer. Some opthalmologists use Avastin in the eye. However, it is not licensed for use in the eye and there have been no large-scale long-term trials of Avastin to officially determine its effectiveness to treat maculopathy.
What’s the procedure?
The treatment is administered during an outpatient appointment by an eye specialist (ophthalmologist) and you will be able to go home afterwards. You will be given antibiotic eye drops to prevent infection, a few days before or just before your treatment.
Anti-VEGF drugs are given as an injection and this may be done in an operating theatre or a clean room. The eye and skin around it will be cleaned to prevent infection, and your face and the area around the eye will be covered by a drape to keep the area sterile. A small clip (a 'speculum') will be used to keep the eye open. Local anaesthetic eye drops will be used to ensure the injection is painless. The needle used is very sharp, small and short. The injection itself only takes a few seconds and feels like a tiny scratch.
Your eye pressure will be measured following treatment.
You will not be required to wear sunglasses after anti-VEGF treatment. You should arrange for someone to drive you home, because the treatment may temporarily blur your vision.
Are there any side-effects?
Your eye pressure may go up for a few hours and, if it remains high, treatment may be required. Your vision may be blurry for several hours afterwards due to the dilating eye drops but this should improve by the next day. You may also see the medicine floating around your eye for the next few weeks.
By one month after your first injection most people will notice some improvement in vision – however, it is recommended that all patients receive further injections at one-monthly intervals until there is no further improvement in vision seen for three consecutive months. When this happens, your treatment is stopped but it is important that your vision is regularly checked to see if further treatment is required.
* Photograph: Science Photo Library
Reviewed: March 2011
Next review: September 2012