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Bethlehem

Intravitreal Injection

Intravitreal injections are commonly used to treat retinal diseases such as:

During an injection procedure, anti-vascular endothelial growth factor (VEGF) inhibitors or ocular steroids are injected directly into the eye to help preserve vision.

Some patients may see an improvement in their vision depending on the nature and severity of the retinal disease.

How is the Intravitreal Injection Procedure Performed?

This procedure is performed in the office.

First, the eye is numbed with anesthetic eye drops to help minimize discomfort. Then, the eye is sterilized with antiseptic eye drops. Finally, the medication is injected directly into the eye through the sclera or white of the eye.

Intravitreal injections may need to be administered as frequently as once a month, depending on the condition being treated, to maintain eye health and vision

What is Expected After an Intravitreal Injection?

Intravitreal injection side effects may include some pain or scratchy sensations, as well as the following:

  • Subconjunctival hemorrhage (blood on the white of the eye)
  • Floaters
  • Increased eye pressure

These side effects are typically mild and either resolve spontaneously or with eye drop medications.

Rare risks include inflammation, infection, bleeding in the eye, retinal tears or detachment, and cataract formation.

It is essential to follow the aftercare instructions in order to minimize these risks.

Download Patient Instructions for Care and Restrictions after Eye Injection.

What do They Treat?

Intravitreal injections are commonly used to treat retinal diseases such as:

Specialized eye injections for macular degeneration, diabetic retinopathy, macular edema, RVO, and uveitis utilize anti-vascular endothelial growth factor (VEGF) inhibitors or ocular steroids, which are injected directly into the eye.

By targeting the root causes of these retinal diseases, the injections effectively halt bleeding and the leakage of blood vessels, thereby safeguarding and preserving vision. Depending on the specific nature and severity of the retinal disease, some patients may even experience improvements in their vision as a result of this treatment.

Medications

Anti-Vascular Endothelial Growth Factor (VEGF) Inhibitors

Avastin®
Avastin, also known as bevacizumab, is another anti-VEGF medication that is used to treat swelling in the macula due to wet age-related macular degeneration, vein occlusion, or diabetes. 

Originally developed to treat metastatic colorectal cancer, Avastin is FDA-approved for that purpose. Its use in the eye is considered off-label; however, studies have shown that Avastin can safely and effectively treat wet macular degeneration and macular edema from diabetes or vein occlusion. 

Beovu®
Beovu, or brolucizumab-dbll, is an anti-VEGF medication that is FDA-approved for the treatment of wet age-related macular degeneration and diabetic macular edema.  

Byooviz®
Byooviz, or ranibizumab-nuna, is a vascular endothelial growth factor (VEGF) inhibitor that is FDA-approved for the treatment of wet age-related macular degeneration, macular edema following retinal vein occlusion (RVO) and myopic choroidal neovascularization. 

Cimerli®
Cimerli, or ranibizumab-eqrn, is a vascular endothelial growth factor (VEGF) inhibitor that is FDA-approved for the treatment of wet age-related macular degeneration, macular edema following retinal vein occlusion (RVO), diabetic macular edema, diabetic retinopathy, and myopic choroidal neovascularization.  

Eylea®
Eylea, also known as aflibercept, is another anti-VEGF medication that is FDA-approved for wet age-related macular degeneration and macular edema due to a retinal vein occlusion or diabetic retinopathy. 

Eylea HD®
Eylea HD, also known as aflibercept, is an anti-VEGF medication that is FDA-approved for the treatment of wet age-related macular degeneration, diabetic macular edema, and diabetic retinopathy.  

Lucentis®
Lucentis, also known as ranibizumab, is a vascular endothelial growth factor (VEGF) inhibitor medication that was FDA-approved in 2006 to treat wet age-related macular degeneration. It was subsequently approved to treat macular edema due to a retinal vein occlusion or diabetic retinopathy. 

Lucentis blocks the effects of VEGF, a protein that causes abnormal blood vessels to grow, leak, and damage the macula. By blocking VEGF, Lucentis can help deter or reverse vision loss experienced by patients with macular edema. Lucentis is designed specifically for use in the eye. 

Vabysmo®
Vabysmo, also known as faricimab-svoa, is the most recent medication that is FDA-approved to treat wet AMD and diabetic macular edema. It consists of an anti-VEGF inhibitor combined with an angiopoietin-2 (Ang-2) inhibitor. Ang-2 is involved in the biological process that results in vascular leakage, so blocking the effect of both Ang-2 and VEGF can be an effective treatment for those with macular edema. 

Intravitreal Injections for Geographic Atrophy

Syfovre®
Syfovre, also known as pegcetacoplan, is FDA-approved to treat geographic atrophy, which refers to the loss of retinal tissue due to advanced dry AMD. Syfovre cannot reverse or halt the gradual loss of central vision, but it can slow the progression of the disease. Therefore, it may benefit certain patients with advanced dry AMD. There is a small potential risk of developing wet AMD over the course of treatment. Otherwise, the side effect profile is on par with most intravitreal injections. 

Izervay®
Izervay, or avacincaptad pegol, is FDA-approved to treat geographic atrophy, the advanced form of dry age-related macular degeneration. Izervay targets C5, a protein, to protect healthy retinal cells and photoreceptors. 

Steroids and Micro-Implants

Iluvien®
Iluvien, also known as the fluocinolone acetonide intravitreal implant, is an absorbable steroid micro-implant designed for use in the eye to treat macular edema from diabetes. The Iluvien micro-implant can be injected into the eye in the office using local anesthesia. As is the case with any intraocular steroid medication, there are potential risks of cataract progression and elevated eye pressure (glaucoma) in addition to the usual risks of any intravitreal injection. 

Ozurdex®
Ozurdex, also known as the dexamethasone intravitreal micro-implant, is an absorbable steroid designed for use in the eye to treat macular edema due to uveitis, diabetic retinopathy, and retinal vein occlusion. The Ozurdex implant is injected into the eye in the office using local anesthesia. 

Triamcinolone
Triamcinolone acetonide is another steroid medication that can be administered by periocular or intravitreal injection to treat macular edema from conditions such as diabetes, retinal vein occlusion, and uveitis. 

Yutiq®
Yutiq, or flucinolone acetonide, is an intravitreal implant that is FDA-approved for the treatment of chronic non-infectious uveitis affecting the posterior segment of the eye. The implant delivers a sustained release of fluocinolone to the eye for up to 36 months. 

Xipere®
Xipere, or triamcinolone acetonide, is a corticosteroid injection that is FDA-approved for the treatment of macular edema associated with uveitis.