Intravitreal injections for Age-Related Macular Degeneration

What are intravitreal injections?

Intravitreal injections are a way to treat certain kinds of macular degeneration. Special drugs are injected into the eye to help slow down vision loss from AMD and in some cases improve sight.

When is it used?

Intravitreal injections may be used to treat some kinds of wet, age-related macular degeneration (AMD) and similar conditions. AMD is a disease that damages the macula in the eye and causes a loss of central vision. The wet form of AMD occurs when new, fragile blood vessels grow under the tissue at the back of the eye (retina). These vessels leak blood and fluid. They can cause scarring and loss of vision.

Medicines that shrink the blood vessels are available. Lucentis is a drug that causes shrinkage of the abnormal blood vessels when it is injected into the eye. The shots need to be repeated every 1 to 3 months. Lucentis can maintain vision in most patients (95%) and improve vision in many patients (25-40%). Lucentis is generally the first choice for treatment of wet AMD.

Macugen is a drug that needs to be injected into the eye every 6 weeks. It can help decrease vision loss. It may be used in types of wet AMD where laser treatments are not possible. Other medicines may soon be available.

How do I prepare for the procedure?

Make sure your provider has your medical history so he or she can check what other treatments you have had. Do not wear eye makeup on the day of the procedure.

What happens during the procedure?

The doctor or technician numbs your eye with special eyedrops. Your eye and eyelids are cleaned with an antiseptic to prevent infection. Your lids are held open with a small speculum. You may feel pressure during the injection but you should not feel sharp pain. The injection is very quick. After the injection, you will stay in your doctor's office for a short time. Your surgeon may monitor you after the injection to make sure the pressure in your eye does not get too high. Your surgeon may prescribe antibiotic drops to be used in the eye for a few days after the injection.

What happens after the procedure?

Usually you will have a follow-up appointment for an exam a month or more after the injection. Most people need several injections over time. Your provider will determine how many treatments you should have.

What are the benefits of this procedure?

Most patients (95%) with neovascular or wet macular degeneration treated with intravitreal injections maintained their vision after 2 years. Vision improved for many patients (25-40%).

What are the risks associated with the procedure?

There is a risk of infection in the eye for the first week after injection. Infection is very rare, but can lead to severe vision loss. If you suspect you may have an infection you should see your eye surgeon immediately. Symptoms of infection include loss of vision, pain, and redness of the eye.

Sometimes there is a small amount of bleeding on the surface of your eye. This is normal and is similar to a bruise. It normally takes 1-2 weeks to resolve.

When should I call my eye care provider?

Call right away if your vision suddenly gets worse, you develop pain, or you develop a new problem with your vision.

Reviewed for medical accuracy by faculty at the Wilmer Eye Institute at Johns Hopkins. Web site: http://www.hopkinsmedicine.org/wilmer/

Written by Alex Leder, MD.
Published by RelayHealth.
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