With wet age-related macular degeneration (AMD), prompt treatment is crucial to help minimize vision loss. For this serious, progressive eye condition, your eye doctor may recommend a procedure called anti-VEGF (vascular endothelial growth factor) treatment.
Anti-VEGF consists of medicated eye injections that target the underlying causes of wet AMD. This treatment is also sometimes recommended for other retinal conditions, such as macular edema caused by diabetes.
For wet AMD, the goal of this treatment is to slow blood vessel leaking beneath the retina, while also decreasing the number of abnormal blood vessels altogether. This can help preserve the macula, which is responsible for central vision.
In fact, anti-VEGF treatment is estimated to prevent further loss of central vision in up to 90 percent of people.
While this treatment is effective, many people have additional questions and may feel nervous about eye injections. Keep reading to learn more about the procedure and what to expect during an anti-VEGF injection.
Anti-VEGF injections contain medications that treat abnormal and leaky blood vessels in your retina. The procedure is performed by a type of eye doctor called an ophthalmologist.
These types of shots are known as intravitreal injections because they’re administered directly into the vitreous cavity in the back of your eye.
There are four types of anti-VEGF medications your doctor may consider for the procedure:
- aflibercept (Eylea)
- bevacizumab (Avastin)
- brolucizumab-dbll (Beovu)
- ranibizumab (Lucentis)
Depending on your condition, your ophthalmologist may inject the medications in both eyes at the same appointment.
Here’s what you can expect during your treatment:
Preparing for treatment
Before the procedure, your doctor will have you lie down in a reclining chair.
They’ll then apply a topical anesthetic to your eyelids and eyes to help prevent any pain from anti-VEGF injections and the cleaning preparation that happens beforehand. These may come in the form of a gel or drops. While you might feel a wet or cool sensation, this shouldn’t feel uncomfortable.
There may also be a local subconjunctival injection of numbing medicine for added comfort.
Next, your ophthalmologist will apply a cleaning solution to your eyes and eyelids. This helps to prevent possible infections from any bacteria that might be residing in your eye area.
Once your eyes are cleaned and numbed with the chosen anesthetic, your doctor will move forward to administer the anti-VEGF injections.
During the process
First, your eye is propped open with a small instrument called an eyelid speculum. This helps to ensure a smooth injection process without the interference of eyelid blinking.
Next, your doctor will guide the injections through the sclera, or white part of your eye. Right before the injection, they may also ask you to look in the opposite direction of the desired administration point.
You may feel slight pressure during your injections, but the procedure shouldn’t cause any pain.
After the injections
Immediately after the injections, your doctor will remove the eyelid speculum. They will also clean your eyes with a saline solution.
In all, anti-VEGF treatment takes 10 to 15 minutes to complete. Most of the procedure time is dedicated to preparation and cleaning, with the injections only taking about 20 seconds each.
You may be prescribed antibiotic eye drops to help prevent infections after your treatment. For post-treatment pain, your doctor may recommend over-the-counter ibuprofen or acetaminophen, as well as a cool washcloth applied directly to your eye at 10-minute intervals.
You’ll be able to go home immediately after your anti-VEGF treatment, though you should get someone to drive you. Your eye(s) may feel sore or gritty for up to 2 days.
It’s also possible to see a small black spot where the injection was administered, but this should go away within a week.
More serious complications, such as bleeding or infections are possible, but rare. Call your doctor if you’re experiencing any bleeding, inflammation, or discharge, as well as any signs of further vision loss.
During the recovery process, you should take care not to rub your eyes, as this will cause irritation and swelling. You’ll also want to avoid dusty environments that might result in eye debris.
After your anti-VEGF treatment, your ophthalmologist will tell you when they would like you to come back to the office for a follow-up appointment to check your eyes and determine the efficacy of the injections.
Depending on your results, you may need to repeat your anti-VEGF treatments every 1 to 2 months.
Your eye doctor may also refer you to an occupational therapist or vision rehabilitation specialist. Both professionals will help you find ways to manage any permanent vision changes you may experience from wet AMD.
While researchers are looking for other, longer-lasting potential treatments for wet AMD in the future, anti-VEGF injections are currently the best available options to prevent further losses to your central vision.
Anti-VEGF injections are considered a highly effective treatment method. They contain medications that help eliminate some of the abnormal blood vessels in your retina. The procedure also stops blood vessels from leaking and further damaging your macula.
You’ll likely need regular follow-up injections to help keep your wet AMD in an inactive state. Besides anti-VEGF treatments, it’s important to talk with your ophthalmologist about other ways you can manage your condition, and what you can expect in the long term.