Intravitreal therapy

 

What is Intravitreal Therapy?

 

Intravitreal therapy is the injection of medicines known as anti-VEGF (e.g. Eylea, Lucentis, Avastin) or steroids (e.g. implant of Dexamethasone-Ozurdex) into your eye with a fine needle. Minimal discomfort can occur (similar to having a blood sample taken from your arm vein). A course of treatment with a series of injections might be needed at certain intervals (e.g. 4 weeks or more).

Who needs Intravitreal Therapy?

 

Patients with retinal conditions associated with abnormal blood vessels, which grow and/or leak within and/or under the retina (at the back of your eye) can benefit from intravitreal therapy. These conditions include:

 

· Wet age-related macular degeneration

· Myopic choroidal neovascularization

· Diabetic macular oedema

· Retinal vein occlusion

· Macular oedema

· Abnormal retinal vessels

· Any other retinal condition causing fluid to leak within and/or under the retina

 

Can I have intravitreal therapy if I am pregnant or breast-feeding?

 

AntiVEGF medicines should be used with caution during pregnancy. If you are expecting or planning to conceive, please, discuss with your doctor before intravitreal therapy. Women of child-bearing potential are advised to use effective contraceptive method(s) while undergoing intravitreal anti-VEGF therapy injections and for at least three months after the last injection. If you do become pregnant while on treatment, please, inform your doctor immediately. Anti-VEGF medicines are not recommended during breastfeeding. It is not understood whether anti-VEGF passes into human milk from the blood system. Speak to your consultant for advice

 

What happens on the day of treatment?

 

The injection is given while you are sitting on a reclining chair (similar to when you go to the dentist). The whole procedure can take 5-10 minutes but the injection itself takes less than 15 seconds. First, your eye is numbed with local anaesthetic eyedrops to reduce discomfort to the very minimum. Then, your eyelids and surface of the eye are cleaned to prevent infection. A small clip will be used to keep the eye open. The injection site is marked with callipers and your eye is stabilised with a cotton bud. A few seconds later, the injection is given. The injecting clinician will use lubricating eye drops after your injection. Your vision will be assessed by asking you to count fingers.

 

What happens after the treatment?

 

There is no benefit from using antibiotic drops after intravitreal therapy. You will just be given lubricants to take home. These will provide some comfort after the injection, and you may use them as often as necessary. Please be aware that you might have to wait to have your pressure checked. Your next appointment will be scheduled the same day or sent to you by post.

 

There are no special precautions following intravitreal injections and you will be able to travel, but please avoid getting water into your eye or swimming for the first few days afterwards.

 

Are there any risks or side effects of this treatment?

 

As with any medical intervention, there is a small risk of side effects or complications following intravitreal therapy. These risks are very rare indeed and significant loss of vision is very uncommon. Overall, the benefit of the treatment outweighs the small risk of complications. These include:

 

  • Red eye (small bleed on the white of the eye at the site of injection, which clears in 1-2 weeks).

  • Gritty eye (foreign body sensation, dryness), which last 1-2 days. The lubricating drops provided to you after the procedure will alleviate these symptoms.

  • ‘Small specks’ in your vision (‘floaters’) can sometimes be seen for a few days after the injection.

  • “Flashing lights or swirls of light” can rarely occur immediately after the injection.

  • Your eye may feel slightly sore or uncomfortable afterwards. You may wish to take mild pain relief, for example paracetamol. If you are already taking pain relief for another condition, continue with these, but do not take both.

 

Please, note that most of the discomfort relating to intravitreal injections is due to the use of Povidone Iodine antiseptic cleaning solution. This is a vital part of the injection process and reduces the risk of infection. You may be sensitive to the iodine. Your injecting physician will make sure to wash it out. Please, note that allergies to iodine are extremely rare.

 

Rare risks of intravitreal injections:

 

  • Serious eye infection (one in 2,000 cases)

  • Detached retina

  • Increased eye pressure

  • Blood clots and bleeding in the eye

  • Inflammation inside the eye

  • Cataract.

 

Please, note that this is not a complete list of potential risks. For a full list of risks, and further information about the medicine injected, please, see the patient information leaflet found inside the drug packet.

How do I make an appointment?

Your Consultant’s secretary will be able to assist you with availability and costs for your chosen consultant. You can find their contact details by clicking on the link below or visiting the Consultants section.

 

 

 

For further information or to book a consultation contact:

Assad Jalil

Niall Patton

Abha Gupta

Marta Ugarte