Injections

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Intravitreal Injections

Depending on the retinal or macular condition, physicians and surgeons often utilize intravitreal injections. This form of care can provide effective targeted treatment, often at higher doses, with little or no pain or discomfort. Injections can be more effective than other options, as eye drops may not deliver enough medication to the inside of the eye, and pills or systemic medications can have serious side effects. Due to their ease and effectiveness, injections are the nation’s most commonly performed ophthalmic procedure. At Retina Consultants of Charleston, we regularly use intravitreal injections to treat various retinal conditions.

What Is the Vitreous?

These injections are applied into the vitreous, also called the vitreous gel or humor – the clear, jelly-like liquid that makes up most of the eye’s volume and supports its structure. The vitreous also provides a pathway for light entering the lens to reach the retina, a thin tissue layer that converts light into electrical signals, allowing you to see.

Intravitreal injections are very effective, as vitreal access enables rapid absorption into the retina. As such, a smaller drug dosage is needed than that delivered via the mouth or intravenously.

Anti-VEGF Medications

In many cases, injections deliver anti-vascular endothelial growth factor (anti-VEGF) medications, the standard treatment for multiple retinal diseases. They’re used to slow abnormal blood vessel growth or prevent blood vessels from leaking fluid in the eye. Among the most well-known anti-VEGF medications are Avastin® (bevacizumab), Lucentis® (ranibizumab), and Eylea® (aflibercept).

Anti-VEGF injections are commonly used to treat such retinal and macular conditions treated as:

• Wet age-related macular degeneration (wet AMD)
• Proliferative diabetic retinopathy
• Central retinal vein and artery occlusions (CRVO and CRAO)
• Branch retinal vein and artery occlusions (BRVO and BRAO)
• Diabetic macular edema

What Is Neovascularization?

These conditions develop due to a process called neovascularization, the natural production of new blood vessels. These blood vessels can cut off the retina or vascular tissues from their steady supply of oxygenated blood required for proper health and function. While the body attempts to repair this issue by growing new blood vessels, they’re abnormal and fragile, resulting in blood and vitreous leaking into the retina.

You may experience eye floaters, hazy vision, edema (swelling), as well as problems with night vision and Iighting changes. Should these symptoms worsen, more serious problems can develop, including retinal tears or detachment, permanent blindness, and the loss of an eye. Anti-VEGF medications help prevent neovascularization by inhibiting those proteins that lead to new blood vessel growth.

What Can I Expect With Intravitreal Injections?

With intravitreal injections, patients typically experience little to no discomfort or pain. To help you prepare, here is what you should know:

• This in-office procedure takes about 10-15 minutes to perform.
• The retina specialist administers a local anesthetic, usually with eye drops, to numb and prevent pain during the injection. They then apply a cotton swab with concentrated lidocaine.
• Your eyes are cleaned with an antiseptic to prevent bacterial infection.
• To keep your eyelid open, they use their fingers or a speculum.
• When your eyelid is secured, the retina specialist instructs you to look in the opposite direction from where the needle is administered.
• The retina specialist uses a very thin needle to inject the medication into your sclera; you may feel a slight pressure.

You may need repeat injections, possibly once a month, to maintain eye health and optimize vision, particularly for chronic conditions, like AMD and diabetic retinopathy. During your examination, the retina specialist will discuss your long-term treatment options. Afterward, depending on the situation, you may see an improvement in vision.

Do Injections Have Any Side Effects?

Following intravitreal injections, you may develop certain side effects. However, they usually don’t last long and can be treated with eye drops. Among these are pain or scratchy sensations; conjunctival hemorrhage, bleeding on the white of the eye; floaters; increased eye pressure; and eye inflammation or bruising. Less common risks include infection, bleeding or redness in the eye, retinal tears or detachment, lens damage, and cataract formation.