Anti-VEGF Eye Injections (Eylea, Lucentis, and Avastin)
Vascular Endothelial Growth Factor (VEGF) is a small protein secreted in many eye conditions such as wet age-related macular degeneration (AMD), retinal vein occlusion (RVO), diabetic macular edema (DME), and diabetic retinopathy (DR). This protein stimulates the growth of abnormal blood vessels and causes edema (fluid leakage and accumulation) in the retina. Anti-VEGF drugs (Lucentis, Eylea, and Avastin) block this protein, diminishing damage. The treatment is best accomplished with eye injections, and the results are often impressive.
These drugs are given via an injection into the eye. Because the injections are a treatment and not a cure, they are typically repeated, often monthly, in order to maximize vision improvement. Another way to think about the treatment is to compare it to chemotherapy for cancer. Chemotherapy is given at regular intervals based on the patient’s response to treatment. It typically requires a long-term commitment to achieve the best results.
At RCTX, we have always been on the cutting edge of research into new treatments for retinal disease. Our practice was one of the largest centers in the country to participate in clinical trials that brought Anti-VEGF drugs to the market. And because of our numerous locations through Texas, we can offer these groundbreaking treatments in a location closest to you. This is
especially important for patients who need regular treatment.
How are anti-VEGF injections administered?
Injections are performed with numbing agents. After being sufficiently numbed, the eye is treated with an antiseptic to kill bacteria and prevent infection. Many physicians use a small instrument called a lid speculum. A lid speculum is inserted between the top and bottom eyelid and the intravitreal injection (injection directly into the vitreous—the jelly that fills your eye) is delivered.
Therapy typically consists of an induction phase consisting of three regularly spaced monthly injections. After this, therapy is tailored to each patient.
We use optical coherence tomography (OCT) to scan the retina and monitor leakage. When leakage is under control, we often attempt to space the injections further apart (we call this “treat and extend”). Many patients can go 6 to 12 weeks between injections. For other patients, leakage into the retina stabilizes, but does not stop entirely. These patients require monthly injections, sometimes indefinitely, to maximize vision preservation.
Eye Injection Frequently Asked Questions
How does the RCTX physician decide which anti-VEGF drug is right for me?
In clinical trials, anti-VEGF agents Lucentis, Eylea, and Avastin injections have all been proven effective in reducing abnormal blood vessel growth and leakage in patients with AMD, RVO, DME, and DR.
- Eylea and Lucentis have been FDA approved for use in all four conditions.
- Avastin is a cancer chemotherapy agent used in very small doses as an “off-label” treatment for all four conditions. Although widely used by many retina specialists, Avastin does not have formal FDA approval for use in the eye.
Your physician will discuss the various indications and benefits, and will work with you and your insurance company to determine which therapy is right for you.
Doesn’t getting an injection into the eye hurt?
No! We take great care to thoroughly numb the eye, and we use a very tiny needle for the injections. Most patients are surprised to discover how painless they are.
What are the risks of anti-VEGF injections?
In rare cases, a patient can develop an infection, retinal detachment, or bleeding after intravitreal injection. These can be managed if diagnosed early. Please notify your doctor if you have severe pain or vision loss after an injection. Your physician will discuss risks and side effects with you.
How long will I need to get intravitreal injections?
There is no practical way to predict how each patient’s eye will respond. Some patients can go 6 to 12 weeks between treatments, some need them monthly. It is helpful to think of this compared to a disease such as diabetes. Insulin does not cure diabetes, but is a very effective treatment. In the same way, these injections go a long way to help preserve your vision.
What happens if I stop anti-VEGF injections?
Numerous trips to the office can be difficult for some patients. However, the results of our extensive research and experience indicate that untreated or under-treated AMD, RVO, or DME can result in damage to the cells of the retina, causing permanent vision loss or even blindness. Our goal is to get each patient’s retina as “dry” as we can with the fewest number of injections and without sacrificing gains in vision.
Do I need to see the same RCTX physician each time?
No. If you would prefer to see the same physician each time, we can provide a schedule and you may choose to travel to a different RCTX location.